Laparoscopic and open partial nephrectomy: cost comparison with analysis of individual parameters

Journal of Endourology
Sangtae ParkYair Lotan

Abstract

Laparoscopic partial nephrectomy (LPN) is less morbid than open partial nephrectomy (OPN), but the high cost of new technologies used in LPN may make this a significantly more expensive procedure. In this study, the overall costs of OPN and LPN were compared using data extracted from the literature, and a series of sensitivity analyses were performed to determine the impact of individual cost components on overall cost. Data on operating room (OR) time, equipment use, and length of stay (LOS) were abstracted after a comprehensive literature review of LPN and OPN. Decision tree models were devised to estimate the cost of each treatment using the DATA program (TreeAge software 3.5). LPN model assumptions included one that used all reusable equipment, all disposable equipment, and a hand-assist model. One and two-way sensitivity analyses were performed to evaluate the effect of individual treatment variables on overall cost. The literature yielded 12 OPN and 13 LPN articles, comprising a total of 574 and 949 patients, respectively. The weighted mean LOS were 5.7 and 2.9 days (<0.001); average tumor sizes were 3.2 cm and 2.5 cm (P = 0.016); and the weighted mean OR times were 184 and 187 minutes for OPN and LPN (P = 0.7), respectiv...Continue Reading

References

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Citations

Jan 21, 2011·Journal of Endourology·Saad A MirYair Lotan
Mar 6, 2012·Journal of Endourology·James E FergusonEric M Wallen
Nov 8, 2012·Journal of Endourology·Mehrdad AlemozaffarAndrew A Wagner
Dec 4, 2009·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Gaurav GuptaNitin S Kekre
Jun 17, 2014·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Daniel R RutzDavid A Kooby

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