BACKGROUND: Incidental appendectomy (IA) remains a controversial issue. The role of IA in the nonmanaged-care setting has not been evaluated recently. This study evaluates the cost-benefit of IA based on current third-party reimbursements and reports the incidence of pathology from routine IA during an 18-year period. STUDY DESIGN: A retrospective review was performed for all patients who underwent open intestinal operations for nonappendiceal pathology by a single colon and rectal surgeon between 1988 and 2006. Patient records were reviewed for surgical indication, procedure, pathology reports, and complications. A cost-benefit analysis for IA versus laparoscopic appendectomy was performed using previously published epidemiologic data for risk of appendectomy. RESULTS: During this period, 341 patients (mean age 62.9 years) underwent IA during open intestinal operation. Malignancy was the indication for operation in 61.6%. Pathologic findings of clinical significance in the appendix were present in 2.6% of specimens. Combined reimbursements for laparoscopic appendectomy for nonruptured and ruptured appendicitis are 8,500.95 dollars and 15,870.37 dollars, respectively. For patients with a benign surgical indication, there was cost-benefit for IA during open operation for men younger than 55 years and women younger than 50 years of age. For patients with malignant disease, there was cost-benefit for men and women younger than 45 years of age. CONCLUSIONS: IA can be performed safely during open operation for other bowel pathology. Rate of clinically significant appendiceal pathology is low but not negligible. For patients with third-party payor status, IA can be more broadly performed during open gastrointestinal operation when no additional surgeon reimbursement is obtained.
BACKGROUND: Incidental appendectomy (IA) remains a controversial issue. The role of IA in the nonmanaged-care setting has not been evaluated recently. This study evaluates the cost-benefit of IA based on current third-party reimbursements and reports the incidence of pathology from routine IA during an 18-year period. STUDY DESIGN: A retrospective review was performed for all patients who underwent open intestinal operations for nonappendiceal pathology by a single colon and rectal surgeon between 1988 and 2006. Patient records were reviewed for surgical indication, procedure, pathology reports, and complications. A cost-benefit analysis for IA versus laparoscopic appendectomy was performed using previously published epidemiologic data for risk of appendectomy. RESULTS: During this period, 341 patients (mean age 62.9 years) underwent IA during open intestinal operation. Malignancy was the indication for operation in 61.6%. Pathologic findings of clinical significance in the appendix were present in 2.6% of specimens. Combined reimbursements for laparoscopic appendectomy for nonruptured and ruptured appendicitis are 8,500.95 dollars and 15,870.37 dollars, respectively. For patients with a benign surgical indication, there was cost-benefit for IA during open operation for men younger than 55 years and women younger than 50 years of age. For patients with malignant disease, there was cost-benefit for men and women younger than 45 years of age. CONCLUSIONS: IA can be performed safely during open operation for other bowel pathology. Rate of clinically significant appendiceal pathology is low but not negligible. For patients with third-party payor status, IA can be more broadly performed during open gastrointestinal operation when no additional surgeon reimbursement is obtained.
Authors: C Hüttenbrink; G Hatiboglu; T Simpfendörfer; J P Radtke; R Becker; D Teber; B Hadaschik; S Pahernik; M Hohenfellner Journal: Langenbecks Arch Surg Date: 2017-11-02 Impact factor: 3.445
Authors: Carlos Theodore Huerta; Andrew Sundin; Antoine J Ribieras; Rebecca Saberi; Walter Ramsey; Gareth Gilna; Hallie J Quiroz; Chad M Thorson; Juan E Sola; Eduardo A Perez Journal: Pediatr Surg Int Date: 2022-08-03 Impact factor: 2.003