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2015 | 87 | 12 | 634-637

Article title

Laparosocopic Appendectomy, Cost-Effectiveness of Three Different Techniques Used to Close the Appendix Stump

Content

Title variants

Languages of publication

EN

Abstracts

EN
It is generally agreed that laparoscopic appendectomy is a valuable operative method.The aim of the study was to evaluate cost-effectiveness of three different techniques used to close the appendix stump.Material and methods. We conducted a retrospective study that compared three groups of patients who were operated on laparoscopically for acute appendicitis in 2013 at our institution. We used an endoscopic clip to close the appendix stump in the first group (n=20), endoscopic stapler was applied in the second group (n=20), and in the third group of patients the appendix base was closed with a laparoscopic suture (n=20). These groups were matched by age, sex and BMI.Results. The average operative cost was the highest in the second group. Cost of the laparoscopic appendectomy with the application of the endoscopic clip was significantly lower (first group) and comparable to the third group. Observed differences in total hospitalization costs were associated only with the chosen appendix stump closure technique.Conclusions. Clip closure of the appendix base is an easy and cost-effective procedure. The laparoscopic suture technique is the cheapest but technically demanding. According to our experience endoscopic stapler may be useful in some cases, although it is the most expensive method.

Publisher

Year

Volume

87

Issue

12

Pages

634-637

Physical description

Dates

published
1 - 12 - 2015
received
1 - 4 - 2016
online
10 - 3 - 2016

Contributors

author
  • 2nd Department of General Surgery of the Jagiellonian University, Medical College in Cracow Kierownik: prof. dr hab. K. Rembiasz
  • 2nd Department of General Surgery of the Jagiellonian University, Medical College in Cracow Kierownik: prof. dr hab. K. Rembiasz
  • 2nd Department of General Surgery of the Jagiellonian University, Medical College in Cracow Kierownik: prof. dr hab. K. Rembiasz

References

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  • 2. Bobrzyński A, Budzyński A, Strzałka M: Laparoskopia ze wskazań doraźnych. Przegl Lek 2002; 59(10): 873.
  • 3. Strzałka M, Bobrzyński A, Budzyński A, Gwóźdź A: Usunięcie wyrostka robaczkowego techniką klasyczną czy laparoskopową? Wideochirurgia i inne techniki małoinwazyjne 2009; 4 (3): 110‑14.
  • 4. Sauerland S, Jaschinski T, Neugebauer EA : Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2010: CD001546.[WoS][Crossref]
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  • 8. Strzałka M, Matyja M, Rembiasz K: Wyniki laparoskopowych appendektomii z użyciem tytanowego klipsa do zamknięcia kikuta wyrostka robaczkowego. Pol Przegl Chir 2014 Dec 18; 86(9): 418‑21.
  • 9. Kazemier G, in’t Hof KH, Saad S, Bonjer HJ, Sauerland S: Securing the appendiceal stump in laparoscopic appendectomy: evidence for routine stapling? Surg Endosc 2006; 20: 1473‑76.[Crossref]
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  • 11. Tiwari MM, Reynoso JF, High R et al.: S Safety, efficacy, and cost-effectiveness of common laparoscopic procedures. Surg Endsocopy 2011 Apr; 25(4): 1127‑35.
  • 12. Gonenc M, Gemici E, Kalayci MU et al.: Intracorporeal knotting versus metal endoclip application for the closure of the appendiceal stump during laparoscopic appendectomy in uncomplicated appendicitis. J Laparoendosc Adv Surg Tech A 2012; 8(3): 231‑35.
  • 13. Haas L, Stargardt T, Schreyoegg J: Cost-effectiveness of open versus laparoscopic appendectomy: a multilevel approach with propensity score matching. Eur J Health Econ 2012 Oct; 13(5): 549‑60.[Crossref][WoS]
  • 14. Rickert A, Bönninghoff R, Post S et al.: Appendix stump closure with titanium clips in laparoscopic appendectomy. Langenbecks Arch Surg 2012 Feb; 397(2): 327‑31.[WoS]
  • 15. Ates M, Dirican A, Ince V et al.: Comparison of intracorporeal knot-tying suture (polyglactin) and titanium endoclips in laparoscopic appendiceal stump closure: a prospective randomized study. Surg Laparosc Endosc Percutan Tech 2012 Jun; 22(3): 226‑31.[Crossref]
  • 16. Gomes C, Soares C Jr, de Peixoto R et al.: Appendiceal stump closure by metal endoclip in the management of complicated acute appendicitis World J Emerg Surg 2013; 8: 35.[WoS]
  • 17. Rickert A, Krüger CM, Runkel N et al.: The TICAP-Study (titanium clips for appendicular stump closure): A prospective multicentre observational study on appendicular stump closure with an innovative titanium clip. BMC Surg 2015 Jul 17; 15: 85.

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_1515_pjs-2016-0015
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