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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Costs and Their Predictors in Transsphenoidal Pituitary Surgery
Anthony O Asemota1, Masaru Ishii1, Henry Brem1
1Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland.
Neurosurgery
|October 20, 2018
Summary
Endoscopic pituitary surgery is more expensive overall and for hospitals than microscopic surgery. Physician payments are similar, with length of stay and health plan predicting costs.
Area of Science:
- Neurosurgery
- Health Economics
- Surgical Outcomes
Background:
- Transsphenoidal surgery is a primary approach for pituitary pathologies.
- Both microsurgical and endoscopic techniques are utilized.
- Limited data exists on the direct costs associated with these transsphenoidal pituitary surgeries.
Purpose of the Study:
- To compare the direct costs of microscopic versus endoscopic transsphenoidal pituitary surgery.
- To identify predictors of cost differences between these surgical techniques.
Main Methods:
- Utilized the Truven MarketScan database (2010-2014).
- Analyzed patients undergoing microscopic and/or endoscopic transsphenoidal pituitary surgery.
- Employed analysis of variance and generalized linear models to assess costs and predictors.
Main Results:
- Endoscopic surgery incurred higher overall total and hospital/facility costs compared to microscopic surgery (P < .001).
- Length of hospital stay (LOS) was the most significant predictor for total and hospital costs.
- Physician payments were comparable between the two techniques (P = .26), with health plan being the strongest predictor.
Conclusions:
- Endoscopic transsphenoidal pituitary surgery is associated with greater overall and hospital/facility expenditures than microsurgery.
- Physician reimbursement does not differ significantly between the techniques.
- LOS and health plan are key factors influencing surgical costs.
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