VATS cost is less than thoracotomy in operable NSCLC patients

Abstract

ACKGROUND AND AIM: Better management of financial resources provided by the govern- ment-based insurance system is one of the important challenges in the administration of hospi- tals. The aim of this study was to compare videothoracoscopic surgery and open thoracotomy regarding cost and hospital stay. METHODS: Eighty-eight patients who underwent video-assisted thoracoscopic surgery (VATS) or open thoracotomy for operable (stage IA–IIIA) non-small cell lung cancer were analyzed retro- spectively. The general cost of hospital treatment, cost of operation, and cost of hospital stay of these patients were compared. RESULTS: A total of 48 lobectomies, 33 wedge resections, 2 segmentectomies, and 5 pneu- monectomies were analyzed. Fifty-eight patients (65.9%) underwent VATS resection, and 30 patients (34.1%) had resection via open thoracotomy. There was no statistically significant dif- ference in terms of gender, age, and pulmonary function test between the groups. The postop- erative hospital stay, intensive care unit stay, was higher in patients who underwent thoracotomy compared with patients who underwent VATS (p=0.006 vs p=0.02). The total hospital cost and the cost of operation for patients operated via VATS were lower compared with the costs for patients operated via thoracotomy (p=0.026 vs p=0.014). When analyzed separately, the cost of VATS lobectomy was lower than that of lobectomy via thoracotomy; however, the difference was not statistically significant (p=0.114). CONCLUSIONS: The total hospital cost and the cost of operation via VATS are lower than the costs of thoracotomy. VATS also leads to a reduced hospital stay. VATS should be considered the gold standard in resectional surgery in patients who need lobectomy, segmentectomy, or wedge resection.