Laparoscopic surgery versus open surgery for gastric cancer: big data analysis based on nationwide administrative claims data

Hyojung Hwang; Jae-Eun Myung; Jeong Woo Yi; Sang-Soo Lee; Joonbeom Park

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저자정보: Hyojung Hwang (Yonsei University) Jae-Eun Myung (Medtronic Korea) Jeong Woo Yi (Medtronic Korea) Sang-Soo Lee (Medtronic Korea) Joonbeom Park (Yonsei University Wonju College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.99 No.3

발행연도: 2020.9

수록면: 138 - 145 (8page)

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Purpose: Accumulated evidence indicates laparoscopic surgery (LS) has the advantages of less wound pain, less blood loss, shorter hospitalization, and faster functional recovery than open surgery (OS). Previous studies have analyzed the advantages of LS based on hospital data. This study is the first to compare surgical outcomes and health economic data using nationwide administrative claims datasets for gastric cancer.
Methods: The claims datasets of the Health Insurance Review and Assessment Service for patients that underwent gastrectomy from May 2012 to April 2017 were analyzed. A total of 76,445 cases (LS, 42,395 and OS, 34,050) were included. Postoperative complications and medical costs were included in the analysis.
Results: We analyzed 76,445 cases of gastrectomy. Analysis showed LS was associated with fewer surgical wound infections (2,114 [6.21%] vs. 1,057 [2.49%], P < 0.001), minor abdominal infections and abscesses (826 [2.43%] vs. 390 [0.92%], P < 0.001), cases of surgery-related peritonitis (50 [0.15%] vs. 31 [0.07%], P = 0.0019), repair surgeries (28 [0.08%] vs. 3 [0.01%], P < 0.001), reoperations (504 [1.48%] vs. 343 [0.81%], P < 0.001), less antibiotic use (1,717 [5.04%] vs. 1,268 [2.99%], P < 0.001), and shorter hospital stays (13.61 days vs. 9.97 days, P < 0.001). However, average medical cost was 510,734 Korean Won (444 US dollar) higher for LS than OS.
Conclusion: The study confirms the clinical benefits of LS over OS for gastrectomy in terms of fewer postoperative complications and shorter hospital stays. However, the average medical cost of LS was higher than that of OS.

#Laparoscopy #Stomach neoplasms

참고문헌 (23)

참고문헌 신청

Korea Central Cancer Registry, National Cancer Center / 2018 / Annual report of cancer statistics in Korea in 2016

Statistics Korea / Cause of death statistics in Korea in 2018

Jun JK / 2017 / Effectiveness of the Korean National Cancer Screening Program in reducing gastric cancer mortality / Gastroenterology 152:1319~1328

Lin JX / 2015 / Surgical outcomes of 2041 consecutive laparoscopic gastrectomy procedures for gastric cancer : a large-scale case control study / PLoS One 10:e0114948

Kitano S / 1994 / Laparoscopy-assisted Billroth I gastrectomy / Surg Laparosc Endosc 4:146~148

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