The Costs and Effects of Laparoscopic Appendectomy in Children | Gastrointestinal Surgery | JAMA Pediatrics | JAMA Network
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January 2004

The Costs and Effects of Laparoscopic Appendectomy in Children

Author Affiliations

From the Departments of Paediatric Surgery (Dr Lintula), Anaesthesiology and Intensive Care (Drs Kokki and Mattila), Paediatric Surgery (Dr Vanamo), and Surgery (Dr Eskelinen), Kuopio University Hospital, and Department of Health Policy and Management, Kuopio University (Dr Valtonen), Kuopio, Finland.

Arch Pediatr Adolesc Med. 2004;158(1):34-37. doi:10.1001/archpedi.158.1.34

Background  Laparoscopic procedures are performed commonly in children. In general, the cost containment of laparoscopic surgery in children has not been evaluated.

Objective  To compare the costs of laparoscopic appendectomy with those of open appendectomy.

Design  Prospective clinical trial between November 1, 1997, and April 30, 2000. For analysis, cost of supplies, operation room use, and recovery in the hospital and after discharge was evaluated. Costs common to both groups were not determined.

Setting  Operations performed in a university hospital.

Patients  Eighty-seven children aged 4 to 15 years who underwent appendectomy for suspected appendicitis. Patients were randomized to laparoscopic or open appendectomy.

Intervention  Laparoscopic appendectomies performed with the same standard set of reusable equipment.

Main Outcome Measures  Cost surplus of the laparoscopic procedure and recovery after surgery were evaluated, to determine the costs and effects of laparoscopic appendectomy compared with those of open appendectomy in children.

Results  Excess operating and complication costs per procedure were 96 euros (EUR) in laparoscopic appendectomy. The increased operative expenses were offset by a shorter hospital stay, resulting in a marginal difference of 53 EUR in itemized total costs between the 2 procedures (total cost, 1023 EUR in the laparoscopic appendectomy group and 970 EUR in the open appendectomy group). After laparoscopic appendectomy, children returned to school and sports earlier than those who had had an open appendectomy.

Conclusion  Laparoscopic appendectomy was marginally more expensive, but it allowed earlier return to normal daily activities than open appendectomy.