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Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass

BACKGROUND: Because of the high prevalence of obesity, there is a growing demand for bariatric surgery worldwide. The objective of this systematic review was to analyze the difference in relation to cost-effectiveness of access route by laparoscopy versus laparotomy of Roux en-Y gastric bypass (RYGB...

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Autores principales: Sussenbach, Samanta Pereira, Silva, Everton Nunes, Pufal, Milene Amarante, Casagrande, Daniela Shan, Padoin, Alexandre Vontobel, Mottin, Cláudio Corá
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063755/
https://www.ncbi.nlm.nih.gov/pubmed/24945704
http://dx.doi.org/10.1371/journal.pone.0099976
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author Sussenbach, Samanta Pereira
Silva, Everton Nunes
Pufal, Milene Amarante
Casagrande, Daniela Shan
Padoin, Alexandre Vontobel
Mottin, Cláudio Corá
author_facet Sussenbach, Samanta Pereira
Silva, Everton Nunes
Pufal, Milene Amarante
Casagrande, Daniela Shan
Padoin, Alexandre Vontobel
Mottin, Cláudio Corá
author_sort Sussenbach, Samanta Pereira
collection PubMed
description BACKGROUND: Because of the high prevalence of obesity, there is a growing demand for bariatric surgery worldwide. The objective of this systematic review was to analyze the difference in relation to cost-effectiveness of access route by laparoscopy versus laparotomy of Roux en-Y gastric bypass (RYGB). METHODS: A systematic review was conducted in the electronic databases MEDLINE, Embase, Scopus, Cochrane and Lilacs in order to identify economic evaluation studies that compare the cost-effectiveness of laparoscopic and laparotomic routes in RYGB. RESULTS: In a total of 494 articles, only 6 fulfilled the eligibility criteria. All studies were published between 2001 and 2008 in the United States (USA). Three studies fulfilled less than half of the items that evaluated the results quality; two satisfied 5 of the required items, and only 1 study fulfilled 7 of 10 items. The economic evaluation of studies alternated between cost-effectiveness and cost-consequence. Five studies considered the surgery by laparoscopy the dominant strategy, because it showed greater clinical benefit (less probability of post-surgical complications, less hospitalization time) and lower total cost. CONCLUSION: This review indicates that laparoscopy is a safe and well-tolerated technique, despite the costs of surgery being higher when compared with laparotomy. However, the additional costs are compensated by the lower probability of complications after surgery and, consequently, avoiding their costs.
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spelling pubmed-40637552014-06-25 Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass Sussenbach, Samanta Pereira Silva, Everton Nunes Pufal, Milene Amarante Casagrande, Daniela Shan Padoin, Alexandre Vontobel Mottin, Cláudio Corá PLoS One Research Article BACKGROUND: Because of the high prevalence of obesity, there is a growing demand for bariatric surgery worldwide. The objective of this systematic review was to analyze the difference in relation to cost-effectiveness of access route by laparoscopy versus laparotomy of Roux en-Y gastric bypass (RYGB). METHODS: A systematic review was conducted in the electronic databases MEDLINE, Embase, Scopus, Cochrane and Lilacs in order to identify economic evaluation studies that compare the cost-effectiveness of laparoscopic and laparotomic routes in RYGB. RESULTS: In a total of 494 articles, only 6 fulfilled the eligibility criteria. All studies were published between 2001 and 2008 in the United States (USA). Three studies fulfilled less than half of the items that evaluated the results quality; two satisfied 5 of the required items, and only 1 study fulfilled 7 of 10 items. The economic evaluation of studies alternated between cost-effectiveness and cost-consequence. Five studies considered the surgery by laparoscopy the dominant strategy, because it showed greater clinical benefit (less probability of post-surgical complications, less hospitalization time) and lower total cost. CONCLUSION: This review indicates that laparoscopy is a safe and well-tolerated technique, despite the costs of surgery being higher when compared with laparotomy. However, the additional costs are compensated by the lower probability of complications after surgery and, consequently, avoiding their costs. Public Library of Science 2014-06-19 /pmc/articles/PMC4063755/ /pubmed/24945704 http://dx.doi.org/10.1371/journal.pone.0099976 Text en © 2014 Sussenbach et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Sussenbach, Samanta Pereira
Silva, Everton Nunes
Pufal, Milene Amarante
Casagrande, Daniela Shan
Padoin, Alexandre Vontobel
Mottin, Cláudio Corá
Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass
title Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass
title_full Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass
title_fullStr Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass
title_full_unstemmed Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass
title_short Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass
title_sort systematic review of economic evaluation of laparotomy versus laparoscopy for patients submitted to roux-en-y gastric bypass
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063755/
https://www.ncbi.nlm.nih.gov/pubmed/24945704
http://dx.doi.org/10.1371/journal.pone.0099976
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