Author of

• 10643

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  P1.07 - Poster Session 1 - Surgery (ID 184)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10662

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    P1.07-019 - Is VATS Lobectomy Too Expensive? A Cost Analyze of Introducing VATS Lobectomy to a Tertiary Care Hospital (ID 1440)

    09:30 - 09:30  |  Author(s): G. Buduhan
    • Abstract

    Background
    Video-assisted thoracoscopic (VATS) lobectomy is being performed more frequently in thoracic centers, but cost is a concern. Earlier studies have shown increased intraoperative but lower postoperative costs over open thoracotomy, but to date there has not been a published cost analyses in North America. The objective of this study is to compare the cost of introducing VATS lobectomy and traditional open lobectomy in a Canadian tertiary care hospital.

    Methods
    A retrospective cost analysis was done comparing 78 VATS to 149 open lobectomies performed over 32 month period. Intraoperative (disposables, operating time) and postoperative costs (days in intensive care, intermediate care and ward units, days requiring acute pain service (APS), readmission) were compared, as well as hospital stay. A secondary analysis was performed to look at the effect on hospital costs of a learning curve for VATS lobectomy.

    Results
    The mean intraoperative, postoperative and total costs for VATS and open lobectomy were $4,770 and $2,166 (p-value = 0.01), $3929 and $5,604 (p < 0.0001), and $8,499 and $7,771 (p= 0.3), respectively. Median hospital stay for VATS and open lobectomy were 4 and 5 days (p< 0.0001), respectively. A significant difference in the intraoperative cost of VATS lobectomy was realized after the first 20 cases, with the mean intraoperative cost decreasing from $5095 to $4510 (p = 0.03).

    Conclusion
    The total costs of VATS and open lobectomy are equivalent. Increased disposables cost and longer operating time account for higher intraoperative cost of VATS; shorter hospital stay and less requirement for APS reduce the VATS postoperative costs. There is a learning curve present when introducing VATS lobectomies to an institution. After 20 cases intraoperative costs reduce significantly with more efficient use of disposables and operating time.