AN ECONOMIC-EVALUATION OF LAPAROSCOPY AND OPEN SURGERY IN THE TREATMENT OF TUBAL PREGNANCY

Background. Laparoscopy has generally replaced open surgery in the tre atment of ectopic pregnancy This study assesses the impact of the intr oduction of laparoscopy in the surgical treatment of tubal pregnancy o n costs. Methods. Consecutive patients undergoing primary surgery for tubal pregnancy between January 1992 and December 1995 were included i n the study. Surgery was performed laparoscopically or by open surgery . Cost for each treatment was calculated by multiplying resources used with calculated resource unit prices. The analysis was stratified for radical and conservative surgery. Results. Data of 255 patients were analysed. Tubal pregnancy was successfully treated in all patients. Co sts per patient were US$ 3,490 for radical open surgery, US$ 1,872 for radical laparoscopic surgery, US$ 3,420 for conservative open surgery and US$ 2,125 for conservative laparoscopic surgery. Differences in c osts were caused by a decreased duration of hospital stay after laparo scopy, and, in case of conservative surgery, by an increased persisten t trophoblast rate after laparoscopy. Conclusions. Laparoscopy is equa lly effective as open surgery in the treatment of tubal pregnancy, and considerably reduces costs.