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dc.contributor.authorFullum, Terrence M.
dc.contributor.authorLadapo, Joseph Abiodun
dc.contributor.authorBorah, Bijan J.
dc.contributor.authorGunnarsson, Candace L.
dc.date.accessioned2011-02-07T17:00:48Z
dc.date.issued2009
dc.identifier.citationFullum, Terrence M., Joseph A. Ladapo, Bijan J. Borah, and Candace L. Gunnarsson. 2009. Comparison of the clinical and economic outcomes between open and minimally invasive appendectomy and colectomy: evidence from a large commercial payer database. Surgical Endoscopy 24(4): 845-853.en_US
dc.identifier.issn0930-2794en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:4706325
dc.description.abstractBackground: Appendectomy and colectomy are commonly performed surgical procedures. Despite evidence demonstrating advantages with the minimally invasive surgical (MIS) approach, open procedures occur with greater prevalence. Therefore, there is still controversy as to whether the MIS approach is safer or more cost effective. Methods: A retrospective analysis was performed using a large commercial payer database. The data included information on 7,532 appendectomies and 2,745 colectomies. Data on the distribution of patient demographic and comorbidity characteristics associated with the MIS and open approaches were reviewed. The corresponding complication rates and expenditures were analyzed. Summary statistics were compared using chi-square tests, and generalized linear models were constructed to estimate expenditures while controlling for patient characteristics. Results: The patients undergoing MIS and open colectomy showed no significant variations in age distribution or marginal age differences for appendectomy. Significantly more patients experienced an infection postoperatively, and procedure-specific complications were more common in the open group for both procedures (P < 0.05). The postsurgical hospital stay was longer for the patients treated using the open techniques, differing an average of half a day for appendectomies and significantly more (4 days) for colectomy (P < 0.05). Readmission rates differed little between the two approaches. Procedures performed through an MIS approach were associated with lower expenditures than for the open technique, with differences ranging from $700 for appendectomy patients (P < 0.05) to $15,200 for colectomy patients (P < 0.05). Conclusions: Minimally invasive appendectomy and colectomy were associated with lower infection rates, fewer complications, shorter hospital stays, and lower expenditures than open surgery.en_US
dc.language.isoen_USen_US
dc.publisherSpringer-Verlagen_US
dc.relation.isversionofdoi:10.1007/s00464-009-0675-0en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846276/pdf/en_US
dash.licenseLAA
dc.subjectabdominalen_US
dc.subjectminimally invasiveen_US
dc.subjecteconomic outcomesen_US
dc.subjectappendectomyen_US
dc.subjectcolectomyen_US
dc.subjectminimally invasive surgery (MIS)en_US
dc.subjectopen procedureen_US
dc.titleComparison of the Clinical and Economic Outcomes Between Open and Minimally Invasive Appendectomy and Colectomy: Evidence from a Large Commercial Payer Databaseen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalSurgical Endoscopyen_US
dash.depositing.authorLadapo, Joseph Abiodun
dc.date.available2011-02-07T17:00:48Z
dash.affiliation.otherHMS^Medicine- Beth Israel-Deaconessen_US
dash.affiliation.otherHMS^Stipendees - MD-PhDen_US
dc.identifier.doi10.1007/s00464-009-0675-0*
dash.contributor.affiliatedLadapo, Joseph Abiodun


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