In-Hospital Costs for Open versus Endoscopic Endonasal Approach for Craniopharyngioma Resection.

Autor: Parasher AK; Department of Otolaryngology: Head and Neck Surgery, University of South Florida, Tampa, Florida, USA.; College of Public Health, University of South Florida, Tampa, Florida, USA., Lerner DK; Department of Otolaryngology: Head and Neck Surgery, Icahn School of Mount Sinai, New York City, New York, USA., Miranda SP; Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Douglas JE; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Glicksman JT; Department of Otolaryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.; Department of Otolaryngology, New England Ear Nose and Throat, Newton, Massachusetts, USA., Alexander T; Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA., Lin T; Department of Otolaryngology-Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania, USA., Ebesutani D; Office of Clinical Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Kohanski M; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Lee JY; Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Storm PB; Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., O'Malley BW Jr; Department of Otolaryngology-Head and Neck Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA., Yoshor D; Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Palmer JN; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Grady MS; Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Adappa ND; Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2023 Jan; Vol. 133 (1), pp. 83-87. Date of Electronic Publication: 2022 Aug 05.
DOI: 10.1002/lary.30313
Abstrakt: Objective: To determine the in-hospital cost implications of an expanded endoscopic endonasal approach (EEEA) for craniopharyngioma resection relative to the traditional open transcranial approach.
Methods: All craniopharyngioma surgeries performed at a single institution over a period from January 1st 2001 to October 31th 2017 were evaluated. The electronic medical record was reviewed for patient factors, tumor characteristics, and cost variables associated with each hospital stay and univariate regression analysis was performed using R software.
Results: Thirty-six patients met study criteria, including 22 undergoing an open approach and 14 undergoing an EEEA. There was a significantly longer average length of stay among patients undergoing open resection (21.5 vs. 10.6 days, p = 0.024). The average total in-hospital cost of a patient undergoing an EEEA was $58979.3 compared to $89142.3 for an open approach (p = 0.127). On univariate regression analysis, the total in-hospital cost for a patient undergoing an open approach relative to an EEEA was $30163.0 (p = 0.127). The open approach was exclusively performed from study onset until April 2010 (16 patients). From April 2010 to August 2013, 6 open approaches and 5 EEEA were performed. The EEEA has been exclusively performed from August 2013 until the conclusion of our study period (9 patients).
Conclusions: There has been a shift toward surgical resection of craniopharyngioma via an EEEA approach for amenable tumors. Our study demonstrates that the EEEA has become the preferred surgical approach at our institution, and shows that the EEEA is associated with shorter postoperative length of stay and lower total in-hospital cost. Laryngoscope, 133:83-87, 2023.
(© 2022 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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