Financial Analysis

Data comparing cost effectiveness of laparoscopic versus open approach to renal tumor resection are scant. During laparoscopic partial nephrectomy, increased costs due to longer operating room time and more expensive equipment may be balanced by shorter length of hospital stay and shorter convalescence time. Retrospective case-matched studies comparing open radical nephrectomy versus open partial nephrec-tomy costs have shown comparable hospital costs (p = 0.81) (77).

Steinberg et al. (127) from Cleveland performed a preliminary, retrospective comparison of the financial data of 15 patients undergoing laparoscopic partial nephrectomy versus 15 patients undergoing open partial nephrectomy. All patients in the two groups had a normal contralateral kidney, comparable tumor size (2.4 cm in the laparoscopic partial nephrectomy group vs. 2.5 cm in the open group, p = 0.50), and uncomplicated perioperative course. When compared to the open group, the laparoscopic partial nephrectomy group was associated with 20.1% greater intraoperative costs (p < 0.001) and 55% lesser postoperative costs (p < 0.001). Overall, hospital costs for laparoscopic partial nephrectomy were 15.6% lesser than open surgery (p = 0.002).

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