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Video-assisted thoracic surgery lobectomy: can we afford it?
Eur J Cardiothorac Surg. 2009 Mar; 35(3):423-8.EJ

Abstract

INTRODUCTION

Although video-assisted thoracoscopic (VATS) lobectomy offers advantages with regard to pain, respiratory function and mobility, concern is often expressed concerning the cost of stapling devices and increased operative time. We have therefore compared the costs of VATS and open lobectomy in order to assess the overall economic sustainability of a VATS programme.

MATERIALS AND METHODS

Between January 2004 and December 2006 346 patients underwent pulmonary lobectomy mainly for stage I or II lung cancer (93 VATS lobectomy, 253 thoracotomy). In the VATS group 47% of patients had an upper lobectomy versus 52% in the open group (p=ns). Direct medical costs (disposables, theatre time, high dependency unit stay, hospital stay) were determined and stratified by lobectomy type.

RESULTS

Mean theatre cost for a VATS lobectomy was 2533+/-230 euro versus 1280+/-54 euro for a thoracotomy lobectomy (p=0.00001). Mean high dependency unit (HDU) cost was 1713+/-236 euro and 2571+/-80 euro for a VATS and a thoracotomy lobectomy, respectively (p=0.00001). Mean cost of hospital stay for a VATS lobectomy was 3776+/-281 euro versus 4325+/-154 euro for an open one (p=0.00001). The overall cost for a VATS lobectomy was 8023+/-565 euro which was less than an open lobectomy 8178+/-167 euro (p=0.0002). VATS bilobectomy was slightly more expensive than an open one: 8702+/-350 euro versus 8655+/-466 euro but this difference (47 euro) was not significant (p=ns).

CONCLUSION

VATS lobectomy is less expensive than conventional lobectomy. Increased theatre costs (disposables and time) are counteracted by shorter hospital stay. Importantly, the reduced HDU and ward bed stays free resources for other patients.

Authors+Show Affiliations

Cardiothoracic Surgery Department, Royal Infirmary of Edinburgh, Edinburgh, UK. gianlucasali@yahoo.comNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19136272

Citation

Casali, Gianluca, and William S. Walker. "Video-assisted Thoracic Surgery Lobectomy: Can We Afford It?" European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 35, no. 3, 2009, pp. 423-8.
Casali G, Walker WS. Video-assisted thoracic surgery lobectomy: can we afford it? Eur J Cardiothorac Surg. 2009;35(3):423-8.
Casali, G., & Walker, W. S. (2009). Video-assisted thoracic surgery lobectomy: can we afford it? European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 35(3), 423-8. https://doi.org/10.1016/j.ejcts.2008.11.008
Casali G, Walker WS. Video-assisted Thoracic Surgery Lobectomy: Can We Afford It. Eur J Cardiothorac Surg. 2009;35(3):423-8. PubMed PMID: 19136272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Video-assisted thoracic surgery lobectomy: can we afford it? AU - Casali,Gianluca, AU - Walker,William S, Y1 - 2009/01/10/ PY - 2008/07/21/received PY - 2008/10/24/revised PY - 2008/11/07/accepted PY - 2009/1/13/entrez PY - 2009/1/13/pubmed PY - 2009/6/9/medline SP - 423 EP - 8 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 35 IS - 3 N2 - INTRODUCTION: Although video-assisted thoracoscopic (VATS) lobectomy offers advantages with regard to pain, respiratory function and mobility, concern is often expressed concerning the cost of stapling devices and increased operative time. We have therefore compared the costs of VATS and open lobectomy in order to assess the overall economic sustainability of a VATS programme. MATERIALS AND METHODS: Between January 2004 and December 2006 346 patients underwent pulmonary lobectomy mainly for stage I or II lung cancer (93 VATS lobectomy, 253 thoracotomy). In the VATS group 47% of patients had an upper lobectomy versus 52% in the open group (p=ns). Direct medical costs (disposables, theatre time, high dependency unit stay, hospital stay) were determined and stratified by lobectomy type. RESULTS: Mean theatre cost for a VATS lobectomy was 2533+/-230 euro versus 1280+/-54 euro for a thoracotomy lobectomy (p=0.00001). Mean high dependency unit (HDU) cost was 1713+/-236 euro and 2571+/-80 euro for a VATS and a thoracotomy lobectomy, respectively (p=0.00001). Mean cost of hospital stay for a VATS lobectomy was 3776+/-281 euro versus 4325+/-154 euro for an open one (p=0.00001). The overall cost for a VATS lobectomy was 8023+/-565 euro which was less than an open lobectomy 8178+/-167 euro (p=0.0002). VATS bilobectomy was slightly more expensive than an open one: 8702+/-350 euro versus 8655+/-466 euro but this difference (47 euro) was not significant (p=ns). CONCLUSION: VATS lobectomy is less expensive than conventional lobectomy. Increased theatre costs (disposables and time) are counteracted by shorter hospital stay. Importantly, the reduced HDU and ward bed stays free resources for other patients. SN - 1873-734X UR - https://www.unboundmedicine.com/medline/citation/19136272/Video_assisted_thoracic_surgery_lobectomy:_can_we_afford_it L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2008.11.008 DB - PRIME DP - Unbound Medicine ER -