Comparing the clinical and economic impact of laparoscopic versus open liver resection.
Comparing the clinical and economic impact of laparoscopic versus open liver resection.
复制标题
DOI：
10.1245/s10434-009-0839-0
复制
发表时间：
2010-04
影响因子：
3.7
通讯作者：
Gamblin TC
中科院分区：
文献类型：
--
作者：
Vanounou T;Steel JL;Nguyen KT;Tsung A;Marsh JW;Geller DA;Gamblin TC
Laparoscopic liver resection has thus far not gained widespread acceptance among liver surgeons. Valid questions remain regarding the relative clinical superiority of the laparoscopic approach as well as whether laparoscopic hepatectomy carries any economic benefit compared with open liver surgery. The aim of this work is to compare the clinical and economic impact of laparoscopic versus open left lateral sectionectomy (LLS). Between May 2002 and July 2008, 44 laparoscopic LLS and 29 open LLS were included in the analysis. Deviation-based cost modeling (DBCM) was utilized to compare the combined clinical and economic impact of the open and laparoscopic approaches. The laparoscopic approach compared favorably with the open approach from both a clinical and economic standpoint. Not only was the median length of stay (LOS) shorter by 2 days in the laparoscopic group (3 versus 5 days, respectively, P = 0.001), but the laparoscopic cohort also benefited from a significant reduction in postoperative morbidity (P = 0.001). Because the groups differed significantly in age and ratio of benign to malignant disease, a subgroup analysis limited to patients with malignant disease was undertaken. The same reduction in LOS and postoperative morbidity was evident within the malignant subgroup undergoing laparoscopic LLS (P = 0.003). The economic impact of the laparoscopic approach was noteworthy, with the laparoscopic approach US$1,527–2,939 more cost efficient per patient compared with the open technique. Our study seems not only to corroborate the safety and clinical benefit of the laparoscopic approach but also suggests a fiscally important cost advantage for the minimally invasive approach.
登录
查看更多内容
影响因子：
2.4
作者：
Choi SB;Park JS;Kim JK;Hyung WJ;Kim KS;Yoon DS;Lee WJ;Kim BR
通讯作者：
Kim BR
影响因子：
3.2
作者：
Gumbs, Andrew A.;Bar-Zakai, Barak;Gayet, Brice
通讯作者：
Gayet, Brice
影响因子：
3.8
作者：
Abu Hilal, M.;McPhail, M. J. W.;Pearce, N. W.
通讯作者：
Pearce, N. W.
DOI：
10.1007/s00464-006-9137-0
发表时间：
2007-04-01
影响因子：
3.1
作者：
Dagher, I.;Proske, J. M.;Franco, D.
通讯作者：
Franco, D.
DOI：
10.1016/j.jamcollsurg.2007.01.025
发表时间：
2007-04-01
影响因子：
5.2
作者：
Vanounou, Tsafrir;Pratt, Wande;Callery, Mark P.
通讯作者：
Callery, Mark P.