Cost Aspects of Radical Nephrectomy for the Treatment of Renal Cell Carcinoma in Korea: Open, Laparoscopic, Robot-Assisted Laparoscopic, and Video-Assisted Minilaparotomy Surgeries.
10.4111/kju.2012.53.8.519
- Author:
Jae Won PARK
1
;
Kyung Hwa CHOI
;
Seung Choul YANG
;
Woong Kyu HAN
Author Information
1. Department of Urology, Urological Science Institute, Yonsei University Health System, Seoul, Korea. hanwk@yuhs.ac
- Publication Type:Original Article
- Keywords:
Cost analysis;
Minimally invasive surgical procedures;
Nephrectomy;
Operative surgical procedures
- MeSH:
Anesthesia;
Carcinoma, Renal Cell;
Costs and Cost Analysis;
Fees and Charges;
Fees, Medical;
Humans;
Laparotomy;
Medically Uninsured;
Nephrectomy;
Surgical Procedures, Minimally Invasive;
Surgical Procedures, Operative
- From:Korean Journal of Urology
2012;53(8):519-523
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to comparatively evaluate the cost-effectiveness of four different types of radical nephrectomy (RN) techniques: open, laparoscopic, robot-assisted laparoscopic, and video-assisted minilaparotomy surgery (VAMS). MATERIALS AND METHODS: Among patients who were diagnosed with renal cell carcinoma and underwent RN, 20 patients were selected who received open, laparoscopic, robot-assisted laparoscopic, or VAMS RN between January 2008 and December 2010. Their medical fees were divided into four categories: procedure and operation, anesthesia, laboratory test, and medical supply fees. The medical costs of the patients were also divided into insured and uninsured costs. RESULTS: The total direct cost of VAMS, open, laparoscopic, and robot-assisted laparoscopic RN were 2,023,791+/-240,757, 2,024,246+/-674,859 (p=0.998), 3,603,557+/-870,333 (p<0.01), and 8,021,902+/-330,157 (p<0.01) Korean Won (KRW, the currency of South Koea), respectively. The total insured cost of VAMS, open, laparoscopic, and robot-assisted laparoscopic RN was 1,904,627+/-231,957, 1,798,127+/-645,602 (p=0.634), 3,039,769+/-711,792 (p<0.01), and 899,668+/-323,508 (p<0.01) KRW, respectively. The total uninsured cost of VAMS, open, laparoscopic, and robot-assisted laparoscopic RN was 119,163+/-24,581, 226,119+/-215,009, 563,788+/-487,798 (p<0.01), and 7,122,234+/-56,117 (p<0.01) KRW, respectively. Medical supply fees accounted for the largest portion of the costs and amounted to 33.43% of the VAMS cost. CONCLUSIONS: VAMS RN is as cost-effective as open surgery. Furthermore, it is comparatively more cost-effective than laparoscopic and robot-assisted laparoscopic RN.
