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The Annals of Thoracic Surgery, Vol 56, 633-635, Copyright © 1993 by The Society of Thoracic Surgeons
SR Hazelrigg, SK Nunchuck, RJ Landreneau, MJ Mack, KS Naunheim, PE Seifert and JE Auer
Video-assisted thoracic surgery (VATS) procedures are now being performed
with increasing frequency. The instrumentation and video equipment continue
to evolve and much of this new technology is expensive. We reviewed our
experience with VATS in our most recent 150 cases for the purpose of cost
analysis. The costs incurred in patients undergoing VATS wedge resection
for nodules (n = 45) were compared with those in similar patients having
wedge resection using open techniques (n = 31). We found that patients who
undergo open resections were more likely to spend time in the intensive
care unit after surgery. The anesthesia costs were similar in the two
groups. Disposable instrument costs were $623 higher for VATS resection;
however, the operative time was shorter (101.4 minutes for VATS versus
122.5 minutes for the open procedure), making the total operating room
costs comparable. The length of hospital stay was shorter after VATS
resection (4.4 days for VATS versus 6.5 days for the open procedure),
resulting in lower total hospital charges in the VATS group; however, this
difference was not statistically significant. The cost of a VATS wedge
resection for removing peripheral nodules is competitive with that of open
techniques. Additional benefits, such as reduced pain, shorter operating
times, and decreased hospital stays, make thoracoscopy a valuable
diagnostic tool. The length of hospital stay, operating room time,
disposable instrument costs, complications, and patient acuity all have an
impact on the total costs and vary for different procedures. The operative
time has shortened and the use of disposable instrumentation has lessened
as our experience with thoracoscopy has increased.(ABSTRACT TRUNCATED AT
250 WORDS)
ARTICLES
Cost analysis for thoracoscopy: thoracoscopic wedge resection
Division of Cardiothoracic Surgery, Southern Illinois University School of Medicine, Springfield 62794-9230.
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