Laparoscopic versus open splenectomy: review of a single-center experience and analysis of costs.

Background: Laparoscopic splenectomy (LS) has become the preferred surgical procedure for the elective treatment of hematologic disorders. Compared to open splenectomy (OS), it results in shorter hospital stay, decreased postoperative pain and faster recovery. The cost-benefit analysis of both procedures has not been fully studied. We hypothesize that LS results in significant savings to all levels of the health care system.
Patients and Methods: We report a single academic institution experience with elective LS. Records (clinical and administrative) from all non trauma splenectomies performed between September 2000 and July 2007 were reviewed. Procedure indication, complications and post-operative outcome were collected. Operating room costs, total hospital charges and net contribution margin were calculated. Data are expressed as median (range 5th-95th percentile) unless otherwise specified. The Fisher’s exact tests and Wilcoxon rank-sum tests were used for comparison between groups.
Results: A total of 110 splenectomies were performed. 71 (64%) were approached laparoscopically (32 males, 39 females, median age 57 years, range19-75) and 39 were performed open (24 males, 16 females, median age 60, range 22-76).10 LS patients (14%) were converted to open due to poor visualization in 7 patients and bleeding in 3 patients. Overall complication rates were 6.5% for LS vs. 15% for OS (p=0.1). There was no mortality in the LS patients vs. 3 in the OS patients (p


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Program Number: P384

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