합병성 충수염에서 복강경 충수절제술: 수술결과 및 비용대비효과에 대한 후향적 분석

Abstract

Purpose: Due to coverage by the nationwide medical insurance system for laparoscopic appendectomy, the laparoscopic approach for complicated appendicitis has been widely performed in Korea. The aim of this study is to evaluate the surgical outcomes and cost effectiveness of laparoscopic appendectomy for complicated appendicitis. Methods: This study included 33 patients who underwent the laparoscopic approach (LA) and 26 patients who underwent the open approach (OA) for the complicated appendicitis between March, 2005 and February, 2010. We compared the outcomes of the length of stay, the complications and the costs. Results: The hospital stay was 4.9 days for LA and 6.2 days for OA. (p＞0.05) The overall complication rates were 21% (7/33) for LA and 27% (7/26) for OA. (p＞0.05) All the complications were managed conservatively and there was no mortality in either group. The total cost and the patient’s charge was \3,390,421 and \1,574,093 for LA and \3,260,523 and \1,493,510 for OA, respectively (p＞0.05). Conclusion: The laparoscopic approach is safe, efficacious and cost effective. It should be the initial procedure of choice for most cases of complicated appendicitis.