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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A Prospective, Observational Cost Comparison of Laparoscopic and Open Appendicectomy in Three Tertiary Hospitals in Nigeria
World Journal of Surgery, Volume 47, No. 12, Year 2023
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Description
Background: The clinical benefits of laparoscopic appendicectomy are well recognized over open appendicectomy. However, laparoscopic procedures are not frequently conducted in many low-and middle-income countries (LMICs) for several reasons, including perceived higher costs. The aim of this study was to assess the feasibility and cost of laparoscopic appendicectomy compared to open appendicectomy in Nigeria. Methods: A multicenter, prospective, cohort study among patients undergoing appendicectomy was conducted at three tertiary hospitals in Nigeria. Data were collected from October 2020 to February 2022 and analyses compared the average healthcare costs at 30 days after surgery. Quantile regression was conducted to identify variables that had an impact on the costs, reported in Nigerian Naira (Naira) and US dollars ($), with standard deviations (SD). Findings: This study included 105 patients, of which 39 had laparoscopic appendicectomy and 66 had open appendicectomy. The average healthcare cost of laparoscopic appendicectomy (147,562 Naira (SD: 97,130) or $355 (SD: 234)) was higher than open appendicectomy (113,556 Naira (SD: 88,559) or $273 (SD: 213)). The average time for return to work was shorter with laparoscopic than open appendicectomy (mean: 8 days vs. 14 days). At the average daily income of $5.06, laparoscopic appendicectomy was associated with 9778 Naira or $24 cost savings in return to work. Further, 5.1% of laparoscopic appendicectomy patients had surgical site infections compared to 22.7% for open appendicectomy. Regression analysis results showed that laparoscopic appendicectomy was associated with $14 higher costs than open appendicectomy, albeit non-significant (p = 0.53). Interpretation: Despite selection bias in this real-world study, laparoscopic appendicectomy was associated with a slightly higher overall cost, a lower societal cost, a lower infection rate, and a faster return to work, compared to open appendicectomy. It is technically and financially feasible, and its provision in Nigeria should be expanded. © 2023, The Author(s).
Authors & Co-Authors
Adisa, Adewale O.
Nigeria, Ife
Obafemi Awolowo University Teaching Hospitals Complex
Kachapila, Mwayi
United Kingdom, Birmingham
University of Birmingham
Ekwunife, Christopher Nonso
Nigeria
Federal Medical Centre Nigeria
Alakaloko, Felix Makinde
Nigeria, Lagos
Lagos University Teaching Hospital
Olanrewaju, Balogun
Nigeria, Lagos
Lagos University Teaching Hospital
Nepogodiev, Dmitri
United Kingdom, Birmingham
University of Birmingham
Aderounmu, Adewale Abdulwasiu
Nigeria, Ife
Obafemi Awolowo University Teaching Hospitals Complex
Igwilo, Innocent O.
Nigeria
Federal Medical Centre Nigeria
Omar, Omar Mohammed
United Kingdom, Birmingham
University of Birmingham
Oppong, Raymond A.
United Kingdom, Birmingham
University of Birmingham
Simoes, Joana F.F.
United Kingdom, Birmingham
University of Birmingham
Bhangu, Aneel Amir
United Kingdom, Birmingham
University of Birmingham
Ademuyiwa, Adesoji O.
Nigeria
Federal Medical Centre Nigeria
Statistics
Authors: 13
Affiliations: 4
Identifiers
Doi:
10.1007/s00268-023-07148-5
ISSN:
03642313
Research Areas
Health System And Policy
Study Design
Cohort Study
Study Approach
Quantitative
Study Locations
Nigeria