A comparative cost analysis study of lobectomy performed via video-assisted thoracic surgery versus thoracotomy in Turkey.

Abstract

IntroductionCost analysis studies performed in western countries report that the overall cost of lobectomies performed via video-assisted thoracic surgery is similar to or less than those performed via thoracotomy. The situation may be different in a developing country.AimWe evaluated the cost differences of these two surgical methods.Material and methodsWe retrospectively reviewed the hospital records of 81 patients who underwent lobectomy either via video-assisted thoracic surgery (n = 32) or via thoracotomy (n = 49). Patient characteristics, pathology, perioperative complications, additional surgical procedures, length of hospital and intensive care unit stay, and outcomes of both groups were recorded. Detailed cost data for medications, anesthesia, laboratory, surgical instruments, disposable instruments and surgery cost itself were also documented. Statistical analyses were performed to compare the groups.ResultsThe two groups were homogeneous in regard to age, sex, pathology and perioperative morbidity. The mean duration of hospitalization in the video-assisted thoracic surgery group was significantly shorter than that of the thoracotomy group (7.78 ±5.11 days vs. 10.65 ±6.57 days, p < 0.05). Overall final mean cost in the video-assisted thoracic surgery group was significantly higher than that of the thoracotomy group ($3970 ±1873 vs. $3083 ±1013, p = 0.002). This significant difference relies mostly on the cost of disposable surgical instruments, which were used much more in the video-assisted thoracic surgery group than the thoracotomy group ($2252 ±1856 vs. $427 ±47, p < 0.05).ConclusionsIn contrast to western countries, a video-assisted thoracic surgical lobectomy may cost more than a lobectomy via thoracotomy in a developing country. More expensive disposable surgical instruments and cheaper hospital stay charges lead to higher overall costs in video-assisted thoracic surgical lobectomy patients.

Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis

“…One hundred and sixty-nine reports of 145 studies met the predefined inclusion criteria and were included in the review. 9…”

A Population-Based Cost Analysis of Thoracoscopic Versus Open Lobectomy in Primary Lung Cancer

“…Recently, a study reported by Alpay et al showed that VATS lobectomy costs were greater than costs from thoracotomy lobectomy. 14 The authors concluded that these findings may have resulted from lower bed fees and higher disposable instrument costs. The total cost of thoracoscopic versus open lobectomy was variable in the above studies.…”

“…Similar to the study performed by Alpay et al, lower bed and manpower costs with higher disposable instrument costs may explain the higher total hospital costs in the thoracoscopic group in our study despite the shorter hospital stays and anesthesia times. 14 …”

“…Several studies have analyzed the cost of thoracoscopic lobectomy compared with other procedures, such as standard or robot-assisted lobectomy. 7 – 14 The total cost of thoracoscopic lobectomy was higher than conventional lobectomy in some studies but not in the others. 7 – 10 , 12 – 14 In this cost-sensitive medical care era, cost may play a role when choosing the type of lobectomy in addition to prognosis and other factors.…”

Minimally Invasive Lateral Thoracotomy (MILT) and Decortication: A Prospective Study on Chronic Organised Empyema and its Outcome

“…23 it is evidently proven the mean duration of stay in hospital shorter but cost doing it of significantly higher in majority of studies. 24 This option not viable in majority of our patients. 25 VATS and RATS have advantage of less pain and lesser complication when it's done for non infective lung diseases.…”