Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy
© 2015, Medical Association of Thailand. All Rights reserved. Objective: To demonstrate potential benefits of three-port hand-assisted laparoscopic sigmoidectomy (HALS) compared with open sigmoidectomy (OS) in terms of short-term outcomes and cost-benefit. Material and Method: A retrospective review...
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th-mahidol.367112018-11-23T17:59:25Z Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy Natthawut Phothong Thawatchai Akaraviputh Vitoon Chinswangwatanakul Asada Methasate Atthaphorn Trakarnsanga Mahidol University Srinakharinwirot University Medicine © 2015, Medical Association of Thailand. All Rights reserved. Objective: To demonstrate potential benefits of three-port hand-assisted laparoscopic sigmoidectomy (HALS) compared with open sigmoidectomy (OS) in terms of short-term outcomes and cost-benefit. Material and Method: A retrospective review of a database of cases that matched 100 sigmoid cancer patients treated with sigmoidectomy at the Department of Surgery, Siriraj Hospital was performed. Short-term outcomes and costs of treatment were collected and analyzed. Results: There were no differences in age, gender, body mass index, American Society of Anesthesiologists’ score, Charlson comorbidity index score, and previous surgery between OS and HALS groups. The three-port HALS group had significantly less blood loss (50 (5-400) mL vs. 120 (10-1,000) mL, p<0.001), faster time to regular diet (64.6±20.7 hours vs. 97.6±52.5 hours, p<0.001), and lower pain score (4.3±1.7 vs. 5.3±1.6, p = 0.008). The hospital-stay related cost was significantly lower in HALS group ($114 ($47-$789) vs. $190 ($57-$1,462), p<0.001). The low rate of infection was a major contributory factor (12% vs. 0%, p = 0.03). This was further emphasized in subgroup analysis of surgical site infection (SSI). While there are great benefits, the operative cost is higher in HALS. However, there is no significant difference in total costs of OS and HALS (US $2,243 ($1,321-$5,241) vs. $1,942 ($1,427-$11,910), p = 0.054). Conclusion: Simplified three-port HALS can be successfully performed with superior short-term outcomes and preserved oncologic outcomes. Cost-benefit advantage was highlighted especially in the area of high rate of SSI. 2018-11-23T10:59:25Z 2018-11-23T10:59:25Z 2015-01-01 Article Journal of the Medical Association of Thailand. Vol.98, No.9 (2015), 864-870 01252208 01252208 2-s2.0-84942096211 https://repository.li.mahidol.ac.th/handle/123456789/36711 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84942096211&origin=inward |
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Medicine Natthawut Phothong Thawatchai Akaraviputh Vitoon Chinswangwatanakul Asada Methasate Atthaphorn Trakarnsanga Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
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© 2015, Medical Association of Thailand. All Rights reserved. Objective: To demonstrate potential benefits of three-port hand-assisted laparoscopic sigmoidectomy (HALS) compared with open sigmoidectomy (OS) in terms of short-term outcomes and cost-benefit. Material and Method: A retrospective review of a database of cases that matched 100 sigmoid cancer patients treated with sigmoidectomy at the Department of Surgery, Siriraj Hospital was performed. Short-term outcomes and costs of treatment were collected and analyzed. Results: There were no differences in age, gender, body mass index, American Society of Anesthesiologists’ score, Charlson comorbidity index score, and previous surgery between OS and HALS groups. The three-port HALS group had significantly less blood loss (50 (5-400) mL vs. 120 (10-1,000) mL, p<0.001), faster time to regular diet (64.6±20.7 hours vs. 97.6±52.5 hours, p<0.001), and lower pain score (4.3±1.7 vs. 5.3±1.6, p = 0.008). The hospital-stay related cost was significantly lower in HALS group ($114 ($47-$789) vs. $190 ($57-$1,462), p<0.001). The low rate of infection was a major contributory factor (12% vs. 0%, p = 0.03). This was further emphasized in subgroup analysis of surgical site infection (SSI). While there are great benefits, the operative cost is higher in HALS. However, there is no significant difference in total costs of OS and HALS (US $2,243 ($1,321-$5,241) vs. $1,942 ($1,427-$11,910), p = 0.054). Conclusion: Simplified three-port HALS can be successfully performed with superior short-term outcomes and preserved oncologic outcomes. Cost-benefit advantage was highlighted especially in the area of high rate of SSI. |
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Mahidol University |
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Mahidol University Natthawut Phothong Thawatchai Akaraviputh Vitoon Chinswangwatanakul Asada Methasate Atthaphorn Trakarnsanga |
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Natthawut Phothong Thawatchai Akaraviputh Vitoon Chinswangwatanakul Asada Methasate Atthaphorn Trakarnsanga |
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Natthawut Phothong |
title |
Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
title_short |
Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
title_full |
Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
title_fullStr |
Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
title_full_unstemmed |
Cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
title_sort |
cost-effective and potential benefits in three-port hand-assisted laparoscopic sigmoidectomy |
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2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/36711 |
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1763487608467357696 |