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01-12-2020 | Appendicitis | Original Article

A systematic review on the cost evaluation of two different laparoscopic surgical techniques among 996 appendectomies from a single center

Authors: Noemi Zorzetti, Augusto Lauro, Samuele Vaccari, Alessandro Ussia, Manuela Brighi, Vito D’andrea, Maurizio Cervellera, Valeria Tonini

Published in: Updates in Surgery | Issue 4/2020

Abstract

Acute appendicitis is one of the main indications for urgent surgery representing a high-volume procedure worldwide. The current spending review in Italy (and not only in this country) affects the health service and warrants care regarding the use of different surgical devices. The aim of our study is to perform a cost evaluation, comparing the use of endoloops and staplers in complicated acute appendicitis (phlegmonous and gangrenous), taking into consideration the cost of the device in relation to the management of any associated postoperative complications. We retrospectively evaluated 996 laparoscopic appendectomies of adult patients performed in the Emergency General Surgery—St. Orsola University Hospital in Bologna (Italy). Surgical procedures together with the related choice of using endoloops or staplers were performed by attending surgeons or resident surgeons supervised by a tutor. A systematic review was performed to compare our outcomes with those reported in the literature. In our experience, the routine use of endoloop leads to a real estimated saving of 375€ for each performed laparoscopic appendectomy, even considering post-operative complications. Comparing endoloop and stapler groups, the total number of complications is significantly lower in the endoloop group. Our systematic review confirmed these findings even if the superiority of one technique has not been proved yet. Our analysis shows that the routine use of endoloop is safe in most patients affected by acute appendicitis, even when complicated, and it is a cost-effective device even when taking into consideration extra costs for potential post-operative complications.

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Title: A systematic review on the cost evaluation of two different laparoscopic surgical techniques among 996 appendectomies from a single center
Authors: Noemi Zorzetti
Augusto Lauro
Samuele Vaccari
Alessandro Ussia
Manuela Brighi
Vito D’andrea
Maurizio Cervellera
Valeria Tonini
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keywords: Appendicitis
Appendicitis
Appendectomy
Published in: Updates in Surgery / Issue 4/2020
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00817-3

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A systematic review on the cost evaluation of two different laparoscopic surgical techniques among 996 appendectomies from a single center

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