Looped suture versus stapler device in pediatric laparoscopic appendectomy: a comparative outcomes and intraoperative cost analysis
| Autor: | Juan E. Sola, Amy E. Wagenaar, Anthony R. Hogan, Miosotys Curbelo, Punam P. Parikh, Holly L. Neville, Jun Tashiro, Eduardo A. Perez |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Operating Rooms medicine.medical_specialty Adolescent Cost effectiveness Cost-Benefit Analysis 03 medical and health sciences 0302 clinical medicine Suture (anatomy) Surgical Stapling medicine Appendectomy Humans Pediatric appendicitis Child Ligation Sutures business.industry General surgery Suture Techniques Pediatric Surgeon General Medicine Length of Stay Appendicitis equipment and supplies Surgery Treatment Outcome surgical procedures operative Child Preschool 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Cost analysis Female Laparoscopy 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Pediatric Surgery. 53:616-619 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2017.05.016 |
| Popis: | Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared.All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations.Two hundred thirty-eight cases were analyzed where looped suture versus stapler LA was performed in 46% and 54% of patients, respectively. Operating room costs were $317.10 and $707.12/person for looped suture and stapler LA, respectively (P0.0001). Difference in cost of $390.02/person was attributed solely to ligation type. On bivariate analysis, rate of in-hospital complications, length of stay, return-to-ER and readmission within 30 days did not significantly differ between groups.A comparative analysis of looped suture versus stapler device during LA for pediatric appendicitis revealed that postoperative complications, length of stay, ER visits and readmissions were not significantly different. Looped suture LA was significantly more cost efficient than stapler LA. In pediatric appendicitis, appendiceal ligation during LA may be performed safely and cost effectively with looped suture versus stapler.Cost effectiveness LEVEL OF EVIDENCE: III. |
| Databáze: | OpenAIRE |
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