Laparoscopic Appendectomy for Complicated Appendicitis: Retrospective Analysis for the Surgical Outcomes and Cost-effectiveness

Choi, Hyun Jung; Kim, Yong Jin; Kim, Zisun; Choi, Yoon Young; Cho, Sung Woo; Woo, Hee Doo; Choi, Dongho; Hur, Kyung Yul; Kim, Jae Joon

Abstract

PURPOSE
Due to coverage by the nationwide medical insurance system for laparoscopic appendectomy, the laparoscopic approach for complicated appendicitis has been widely performed in Korea. The aim of this study is to evaluate the surgical outcomes and cost effectiveness of laparoscopic appendectomy for complicated appendicitis.
METHODS
This study included 33 patients who underwent the laparoscopic approach (LA) and 26 patients who underwent the open approach (OA) for the complicated appendicitis between March, 2005 and February, 2010. We compared the outcomes of the length of stay, the complications and the costs.
RESULTS
The hospital stay was 4.9 days for LA and 6.2 days for OA. (p>0.05) The overall complication rates were 21% (7/33) for LA and 27% (7/26) for OA. (p>0.05) All the complications were managed conservatively and there was no mortality in either group. The total cost and the patient's charge was Won 3,390,421 and Won 1,574,093 for LA and Won 3,260,523 and Won 1,493,510 for OA, respectively (p>0.05).
CONCLUSION
The laparoscopic approach is safe, efficacious and cost effective. It should be the initial procedure of choice for most cases of complicated appendicitis.