Cost-effectiveness of laparoscopic  versus  open appendectomy in developing nations: a Colombian analysis

Ruíz-Patiño, Alejandro; Rey, Samuel; Molina, German; Domínguez-Torres, Luis Carlos; Rugéles, Saúl

doi:10.1016/j.jss.2017.11.007

Cited by 25 publications

(34 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopy affords diagnostic advantages that have proved useful in identifying concurrent or alternative pathology [64]; and when compared with ultrasonography, CT, and MRI, diagnostic laparoscopy is cost effective (equipment cost ratio of 1:500:2500:4500) with a low complication rate (0.09%) [98]. Laparoscopic appendectomy was costeffective compared with open appendectomy in a Colombian cohort with an incremental cost-effectiveness ratio (ICER) of US$25.86 [99]. Moreover, in a Nigerian population, the approach decreased the rate of incidental appendectomy and the length of the post-operative hospital stay [72].…”

Section: Adoption Of Laparoscopic Appendectomy In Lmhdicsmentioning

confidence: 99%

Appendicitis in Low-Resource Settings

Bessoff

Forrester

2020

Surgical Infections

View full text Add to dashboard Cite

Background: Acute appendicitis is one of the most common surgical emergencies globally. Its incidence is increasing in low-and middle-Human Development Index countries (LMHDICs). Although a proportion of patients can be treated successfully with non-operative management consisting of antibiotics, supportive therapy, and close observation, current diagnostic algorithms lack the granularity to identify these patients accurately. Methods: We reviewed published literature describing practice patterns and clinical outcomes for appendicitis in LMHDICs and compared them with studies from high-Human Development Index countries, as well as guidelines published by international surgical societies. Results: We identified shortcomings in current diagnostic and therapeutic strategies used in LMHDICs. Delays in obtaining surgical care inherent in many LMHDIC healthcare systems make prompt surgical care the mainstay for the treatment of acute appendicitis. Laparoscopic appendectomy leads to better outcomes than open appendectomy in resource-constrained settings and when available should be the surgical technique of choice. Conclusions: Acute appendicitis is common in LMHDICs, and if possible, laparoscopic appendectomy should be the procedure of choice.

show abstract

Section: Adoption Of Laparoscopic Appendectomy In Lmhdicsmentioning

confidence: 99%

Appendicitis in Low-Resource Settings

Bessoff

Forrester

2020

Surgical Infections

View full text Add to dashboard Cite

show abstract

“…Dessa forma, nota-se que, apesar de o número de videolaparoscopias estar aumentando progressivamente nos países em desenvolvimento e já ser uma realidade consolidada em países desenvolvidos e centros médicos bem estruturados, ainda persiste a dúvida sobre qual a via de acesso ideal para a realização das apendicectomias 7,[11][12] .…”

Section: Introductionunclassified

Apendicectomia aberta versus apendicectomia videolaparoscópica: uma análise a curto prazo

Stahelin¹,

Silva²,

Amaral³

et al. 2020

ACS

View full text Add to dashboard Cite

Introdução: Apendicectomia é uma cirurgia frequente nas situações de emergência, podendo ser realizada por via aberta ou videolaparoscópica. Objetivo: Analisar resultados e possíveis diferenças entre apendicectomias aberta e videolaparoscópica. Almeja-se caracterizar epidemiologicamente pacientes operados e avaliar os desfechos de ambas as técnicas a curto prazo. Métodos: Análise de coorte histórica de 238 pacientes diagnosticados com apendicite aguda e submetidos à apendicectomia aberta ou videolaparoscópica no Hospital Regional de São José Dr. Homero de Miranda Gomes, em Santa Catarina, Brasil, no período de 01 de Maio de 2017 a 30 de Abril de 2018. Resultados: Dentre os pacientes analisados, 209 (87,8%) foram submetidos à apendicectomia aberta e 29 (12,2%) à apendicectomia videolaparoscópica. O número total de homens operados superou o de mulheres (141 versus 97), entretanto, houve mais mulheres operadas pela via videolaparoscópica (58,7%; p = 0,04). Nas duas abordagens, a apresentação transoperatória mais comum da apendicite aguda foi a fase supurativa e houve maior prevalência de doentes entre 21 e 30 anos. A via videolaparoscópica apresentou menor taxa de infecção do sítio operatório(3,4% versus 14,8% na via aberta), apesar dessa diferença não ser estatisticamente significativa. O tempo médio do ato operatório foi mais longo (p<0,01) nas cirurgias videolaparoscópicas (86 ± 27,37 minutos versus 62,7 ± 23,80 minutos). Nos quesitos tempo de internação hospitalar e dor abdominal pós-operatória, ambas as abordagens se demonstraram semelhantes. Conclusão: No hospital avaliado, a maioria das apendicectomias foram realizadas por via aberta e a maior parte das apendicectomias videolaparoscópicas foram realizadas em mulheres. A técnica videolaparoscópica apresentou maior tempo médio de execução. Não houve diferenças significativas em relação a taxas de infecção do sítio operatório, dor pós-operatória e tempo de internação hospitalar.

show abstract

“…As a common in ammatory disease of the abdominal cavity, appendicitis is a common cause of abdominal and periumbilical pain in patients in emergency surgery. Surgical resection has been the preferred treatment [1,2]. Compared with non-surgical treatment, the success rate of appendectomy is high and the length of stay (LOS) is short, which is the gold standard for the treatment of appendicitis [3].…”

Section: Introductionmentioning

confidence: 99%

“…As the world's most populous and largest developing country, China has limited medical and health resources. Cost control for patients undergoing appendicitis surgery is of considerable signi cance to reduce the burden of medical treatment and the increase in medical expenses [2].…”

Section: Introductionmentioning

confidence: 99%

Path Analysis of Hospitalization Expenses of 2,164 Appendicitis Patients at County-Level Public Hospitals in Anhui Province, China

Xue

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background and objectiveAppendicitis resection is one of the most common surgical procedures in China. Hospitalization expenses are a major determinant of appendicitis treatment. This study explored the factors influencing hospitalization expenses of appendicitis surgery patients in Anhui province and provided a scientific basis for reasonably controlling medical expenses.MethodsA multi-stage random cluster sampling method was used to collect case information on 2,164 patients who underwent appendicitis surgery at 6 county-level public hospitals in Anhui province, China. Path analysis was used to study the factors influencing hospitalization expenses of appendicitis surgery patients.ResultsThe average length of stay (LOS) was 5.62 ± 2.64 days, with a median of 5 days; the average hospitalization expenses were 6,109.60 ± 2,109.44 CNY, with a median of 5,511.93 CNY. The direct effect of LOS was 0.535, which was the most important direct factor affecting hospitalization expenses, and the remaining path coefficient was 0.699. surgical grades, surgical methods, and chronic appendicitis directly affected hospitalization expenses, with direct effects of 0.149, 0.081, and -0.037; surgical costs, anesthesia costs, disease outcomes, age, acute simple appendicitis, and operative duration (OD) not only directly affected hospitalization expenses, but also indirectly affected hospitalization expenses through the LOS, and the total effects were 0.283, 0.045, 0.200, 0.202, -0.162, and 0.062, respectively. The total number of surgeons and assistants only indirectly affected the hospitalization expenses through the LOS, and the indirect effect was 0.020.ConclusionsThe LOS is the most important factor affecting hospitalization expenses. Controlling hospitalization expenses is an effective method of reducing the economic burden of patients undergoing appendicitis surgery and decreasing hospital medical expenditures. Based on controlling the average LOS, combined with other comprehensive measures such as decreasing the OD and health education, strengthening controllable factors, and effectively managing the unreasonable increase in hospitalization expenses.

show abstract

Cost-effectiveness of laparoscopic versus open appendectomy in developing nations: a Colombian analysis

Cited by 25 publications

References 6 publications

Appendicitis in Low-Resource Settings

Appendicitis in Low-Resource Settings

Apendicectomia aberta versus apendicectomia videolaparoscópica: uma análise a curto prazo

Path Analysis of Hospitalization Expenses of 2,164 Appendicitis Patients at County-Level Public Hospitals in Anhui Province, China

Contact Info

Product

Resources

About