Looped suture versus stapler device in pediatric laparoscopic appendectomy: A comparative outcomes and intraoperative cost analysis

Punam P. Parikh, Jun Tashiro, Amy E. Wagenaar, Miosotys Curbelo, Eduardo Perez, Holly Neville, Anthony Richard Hogan, Juan E Sola

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. Methods: All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations. Results: Two hundred thirty-eight cases were analyzed where looped suture versus stapler LA was performed in 46% and 54% of patients, respectively. Operating room costs were $317.10 and $707.12/person for looped suture and stapler LA, respectively (P. <. 0.0001). Difference in cost of $390.02/person was attributed solely to ligation type. On bivariate analysis, rate of in-hospital complications, length of stay, return-to-ER and readmission within 30 days did not significantly differ between groups. Conclusion: A comparative analysis of looped suture versus stapler device during LA for pediatric appendicitis revealed that postoperative complications, length of stay, ER visits and readmissions were not significantly different. Looped suture LA was significantly more cost efficient than stapler LA. In pediatric appendicitis, appendiceal ligation during LA may be performed safely and cost effectively with looped suture versus stapler. Type of study: Cost effectiveness. Level of evidence: III.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - Feb 27 2017

Fingerprint

Appendectomy
Sutures
Pediatrics
Costs and Cost Analysis
Equipment and Supplies
Ligation
Appendicitis
Length of Stay
Operating Rooms
Chi-Square Distribution
Cost-Benefit Analysis

Keywords

  • Laparoscopic appendectomy
  • Looped suture
  • Pediatric
  • Stapler

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

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title = "Looped suture versus stapler device in pediatric laparoscopic appendectomy: A comparative outcomes and intraoperative cost analysis",
abstract = "Background: Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. Methods: All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations. Results: Two hundred thirty-eight cases were analyzed where looped suture versus stapler LA was performed in 46{\%} and 54{\%} of patients, respectively. Operating room costs were $317.10 and $707.12/person for looped suture and stapler LA, respectively (P. <. 0.0001). Difference in cost of $390.02/person was attributed solely to ligation type. On bivariate analysis, rate of in-hospital complications, length of stay, return-to-ER and readmission within 30 days did not significantly differ between groups. Conclusion: A comparative analysis of looped suture versus stapler device during LA for pediatric appendicitis revealed that postoperative complications, length of stay, ER visits and readmissions were not significantly different. Looped suture LA was significantly more cost efficient than stapler LA. In pediatric appendicitis, appendiceal ligation during LA may be performed safely and cost effectively with looped suture versus stapler. Type of study: Cost effectiveness. Level of evidence: III.",
keywords = "Laparoscopic appendectomy, Looped suture, Pediatric, Stapler",
author = "Parikh, {Punam P.} and Jun Tashiro and Wagenaar, {Amy E.} and Miosotys Curbelo and Eduardo Perez and Holly Neville and Hogan, {Anthony Richard} and Sola, {Juan E}",
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T1 - Looped suture versus stapler device in pediatric laparoscopic appendectomy

T2 - A comparative outcomes and intraoperative cost analysis

AU - Parikh, Punam P.

AU - Tashiro, Jun

AU - Wagenaar, Amy E.

AU - Curbelo, Miosotys

AU - Perez, Eduardo

AU - Neville, Holly

AU - Hogan, Anthony Richard

AU - Sola, Juan E

PY - 2017/2/27

Y1 - 2017/2/27

N2 - Background: Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. Methods: All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations. Results: Two hundred thirty-eight cases were analyzed where looped suture versus stapler LA was performed in 46% and 54% of patients, respectively. Operating room costs were $317.10 and $707.12/person for looped suture and stapler LA, respectively (P. <. 0.0001). Difference in cost of $390.02/person was attributed solely to ligation type. On bivariate analysis, rate of in-hospital complications, length of stay, return-to-ER and readmission within 30 days did not significantly differ between groups. Conclusion: A comparative analysis of looped suture versus stapler device during LA for pediatric appendicitis revealed that postoperative complications, length of stay, ER visits and readmissions were not significantly different. Looped suture LA was significantly more cost efficient than stapler LA. In pediatric appendicitis, appendiceal ligation during LA may be performed safely and cost effectively with looped suture versus stapler. Type of study: Cost effectiveness. Level of evidence: III.

AB - Background: Appendiceal ligation during pediatric laparoscopic appendectomy (LA) may be performed using looped suture versus stapler. Controversy regarding the utility of either method exists. Clinical outcomes and cost analysis of LA with both methods were compared. Methods: All pediatric LA were performed from fiscal years 2013 and 2014 by two pediatric surgeons. While one surgeon used looped suture, the other used stapler exclusively. chi-Square tests were performed to analyze associations. Results: Two hundred thirty-eight cases were analyzed where looped suture versus stapler LA was performed in 46% and 54% of patients, respectively. Operating room costs were $317.10 and $707.12/person for looped suture and stapler LA, respectively (P. <. 0.0001). Difference in cost of $390.02/person was attributed solely to ligation type. On bivariate analysis, rate of in-hospital complications, length of stay, return-to-ER and readmission within 30 days did not significantly differ between groups. Conclusion: A comparative analysis of looped suture versus stapler device during LA for pediatric appendicitis revealed that postoperative complications, length of stay, ER visits and readmissions were not significantly different. Looped suture LA was significantly more cost efficient than stapler LA. In pediatric appendicitis, appendiceal ligation during LA may be performed safely and cost effectively with looped suture versus stapler. Type of study: Cost effectiveness. Level of evidence: III.

KW - Laparoscopic appendectomy

KW - Looped suture

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KW - Stapler

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