Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)
Online ISSN : 1882-4781
Print ISSN : 1340-2242
ISSN-L : 1340-2242
Treatment Strategy in Consideration of Medical Costs for Acute Appendicitis
Ryosuke NakagawaChihiro KosugiKeiji KodaMasato SuzukiMasato YamazakiToru TezukaKenichiro ImaiAtsushi HiranoKurodo KoshinoRisa ShiragamiHideki Yasuda
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2012 Volume 32 Issue 4 Pages 757-763

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Abstract
Background: 66 patients who underwent surgery for acute appendicitis from October, 2007 to October, 2010 were reviewed. Of these, 32, 27 and 7 underwent Open appendectomy (OA), Laparoscopic appendectomy (LA) and Single Incision Laparoscopic appendectomy (SA), respectively. Methods: We examined the relationship of the operation method which was classified into 3 groups to the preoperative diagnosis and costs performance. Results: In the preoperative diagnosis, there were significant differences in the existence of ileocecal inflammation between OA (40.6%) and LA+SA (11.8%) (p=0.007). In the postoperative treatment outcome and progress, LA+SA was statistically better in the amount of bleeding, postoperative effluent gas, time period until ingestion started, hospitalization and the point of DPC (Diagnosis Procedure Combination) per day on hospitalization than OA (p<0.05). Conclusion: We have often experienced many cases in which OA was not necessary, because surgery could be accomplished via laparoscopy. It would appear that SA should be performed first, but the surgeon should be prepared to convert the surgical method to LA if the operation is difficult to accomplish with SA. Finally, an effort should be made to reduce the medical costs for SA.
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© 2012 Japanese Society for Abdominal Emergency Medicine
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