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- Title
Comparing the Cost and Outcomes of Laparoscopic versus Open Appendectomy for Perforated Appendicitis in Children.
- Authors
GROVES, LESLIE B.; LADD, MITCHELL R.; GALLAHER, JARED R.; SWANSON, JOHN; BECHER, ROBERT D.; PRANIKOFF, THOMAS; NEFF, LUCAS P.
- Abstract
Although laparoscopic appendectomy (LA) is accepted treatment for perforated appendicitis (PA) in children, concerns remain whether it has equivalent outcomes with open appendectomy (OA) and increased cost. A retrospective review was conducted of patients younger than age 17 years treated for PA over a 12.5-year period at a tertiary medical center. Patient characteristics, pre-operative indices, and postoperative outcomes were analyzed for patients undergoing LA and OA. Of 289 patients meeting inclusion criteria, 86 had LA (29.8%) and 203 OA (70.2%), the two groups having equivalent patient demographics and preoperative indices. Inpatient costs were not significantly different between LA and OA. LA had a lower rate of wound infection (1.2 vs 8.9%, P = 0.017), total parenteral nutrition use (23.3 vs 50.7%, P < 0.0001), and length of stay (5.56 ± 2.38 days vs 7.25 ± 3.77 days, P = 0.0001). There was no significant difference in the rate of postoperative organ space abscess, surgical re-exploration, or rehospitalization. In children with PA, LA had fewer surgical site infections and shorter lengths of hospital stay compared with OA without an increase in inpatient costs.
- Subjects
APPENDIX surgery; APPENDECTOMY; LAPAROSCOPIC surgery; PEDIATRIC surgery; MEDICAL care costs; MEDICAL economics; ECONOMICS
- Publication
American Surgeon, 2013, Vol 79, Issue 9, p861
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/000313481307900915