Lee Ho Jun, Park Yong Hwan, Kim Jae Il, Choi Pyong Wha, Park Je Hoon, Heo Tae Gil, Lee Myung Soo, Kim Chul Nam, Chang Surk Hyo
Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 Nov;81(5):321-5. doi: 10.4174/jkss.2011.81.5.321. Epub 2011 Nov 1.
Laparoscopic appendectomy has been recognized to have many advantages such as greater cosmetic results, less postoperative pain and shorter hospital stays. On the other hand, the cost of laparoscopic procedures is still more expensive than that of open procedures in Korea. The aim of this study is to compare clinical outcomes and hospital costs between open appendectomy and laparoscopic appendectomy.
Between January 1, 2010 and December 31, 2010, 471 patients were diagnosed with acute appendicitis. Of these, 418 patients met the inclusion criteria and were divided into two groups of open appendectomy (OA) group and laparoscopic appendectomy (LA) group. We analyzed the clinical data and hospital costs.
The mean operation time for laparoscopic appendectomy (72.17 minutes) was significantly longer than that of open appendectomy (46.26 minutes) (P = 0.0004). The mean amounts of intravenous analgesics for OA group (2.00 times) was greater than that of LA group (1.86 times) (P < 0.0001). The complication rate was similar between the two groups (OA, 6.99% vs. LA, 10.87%; P = 0.3662). The mean length of postoperative hospital stay was shorter in LA group (OA, 4.55 days vs. LA, 3.60 days; P = 0.0002). The mean total cost covered by the National Health Insurance was more expensive in LA group (OA, 1,259,842 won [Korean monetary unit] vs. LA, 1,664,367 won; P = 0.0057).
Clinical outcomes of laparoscopic appendectomy were superior to that of open appendectomy even though the cost of laparoscopic appendectomy was more expensive than that of open appendectomy. Whenever surgeons manage a patient with appendicitis, laparoscopic appendectomy should be considered as the procedure of choice.
腹腔镜阑尾切除术已被公认为具有诸多优点，如美容效果更佳、术后疼痛减轻以及住院时间缩短。另一方面，在韩国，腹腔镜手术的费用仍比开放手术昂贵。本研究的目的是比较开放阑尾切除术和腹腔镜阑尾切除术的临床结果及住院费用。
在2010年1月1日至2010年12月31日期间，471例患者被诊断为急性阑尾炎。其中，418例患者符合纳入标准，被分为开放阑尾切除术（OA）组和腹腔镜阑尾切除术（LA）组两组。我们分析了临床数据和住院费用。
腹腔镜阑尾切除术的平均手术时间（72.17分钟）显著长于开放阑尾切除术（46.26分钟）（P = 0.0004）。OA组静脉镇痛剂的平均使用量（2.00次）大于LA组（1.86次）（P < 0.0001）。两组的并发症发生率相似（OA组为6.99%，LA组为10.87%；P = 0.3662）。LA组术后平均住院时间较短（OA组为4.55天，LA组为3.60天；P = 0.0002）。国家健康保险支付的平均总费用在LA组更高（OA组为1,259,842韩元[韩国货币单位]，LA组为1,664,367韩元；P = 0.0057）。
尽管腹腔镜阑尾切除术的费用高于开放阑尾切除术，但其临床结果优于开放阑尾切除术。每当外科医生处理阑尾炎患者时，腹腔镜阑尾切除术都应被视为首选手术方式。
