VATS cost is less than thoracotomy in operable NSCLC patients

Abstract

BACKGROUND AND AIM: Better management of financial resources provided by the government-based insurance system is one of the important challenges in the administration of hospitals. 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 retrospectively. 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 pneumonectomies 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 difference in terms of gender, age, and pulmonary function test between the groups. The postoperative 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.