Laparoscopic versus open appendectomy

BACKGROUND: Laparoscopic appendectomy is commonly performed and has been pr esumed to offer economic benefits similar to those of laparoscopic cholecys tectomy. This study was done to examine that premise. METHODS: TWO surgical groups contributed consecutively operated patients wi th a clinical diagnosis of appendicitis. One group did all appendectomies o pen and the other group did them laparoscopically. Hospital expenses were c ompared using a single billing formula. Hospital length of stay, time to re turn to work, and complications were analyzed. RESULTS: Operating room times were longer for the laparoscopic group, media n 80 minutes, versus median 50 minutes for the open group. Hospital length of stay and return to work were the same, median 1 day and median 10 days, respectively. Wound complications were less common in the laparoscopic grou p, 0 of 30, than in the open group, 3 of 18; however, there was 1 intra-abd ominal abscess in the laparoscopic group. Median cost of the laparoscopic g roup was $2,915 versus $1,747 for the open group. CONCLUSIONS: Laparoscopic appendectomy is more expensive than appendectomy but does not reduce hospital length of stay nor change the time to return t o work; however, wound complications are less common. (C) 2000 by Excerpta Medica, Inc.