FINANCIAL IMPACT IN THE ITALIAN HEALTH-SERVICE OF LAPAROSCOPIC VERSUSLAPAROTOMIC SURGERY FOR THE TREATMENT OF OVARIAN CYSTS

To assess the cost of two procedures for the removal of ovarian cysts, 200 pre-menopausal women were recruited for the surgical removal of o varian cysts by laparoscopy (n = 100) and laparotomy (n = 100) accordi ng to case-control criteria. Patients operated by laparoscopy (mean ag e +/- SD 32.22 +/- 9.98 years) and laparotomy (mean age +/- SD 29.57 /- 6.62 years) for ovarian cysts (mean diameters +/- SD 4.98 +/- 3.62 and 4.83 +/- 2.78 cm) had a post-surgical hospital stay of 3.12 +/- 0. 41 and 7.25 +/- 1.08 days (P < 0.001) respectively, The total rate of complications occurring in patients operated by laparoscopy was 9 vers us 53% (P < 0.001) of those operated by laparotomy; body temperature > 38 degrees C was recorded in 52/100 of patients operated by laparotomy versus 6/100 of those operated by laparoscopy. The mean cost for each pure surgical treatment performed by laparoscopy was US $498.17 versu s US $642.47 when it was performed by laparotomy (P < 0.001), The lapa roscopic surgical approach is more expensive in the first 36 operation s, thereafter becoming cheaper, The mean of the entire overall expendi ture was US $1142.08 and US $2138.72 for laparoscopy and laparotomy (P < 0.001) respectively. The entire expenditure for laparoscopy is high er than laparotomy only until eight operations. In conclusion, laparos copy versus laparotomy has resulted in a saving of US $14 429.3 for 10 0 operations while the saving on entire costs was US $99 664.8.