Clinical and economic comparative analysis of laparotomy versus laparoscopy in the first gastric bypass surgeries in a bariatric and metabolic surgery service in a city in southern Brazil

ABSTRACT Introduction: this paper aims to evaluate the main direct and indirect costs of the first laparotomies and laparoscopies in bariatric surgeries with a clinical-economical retrospective and cross-sectional analysis from 2017 to 2020 at a hospital with specialties besides the basic ones in southern Brazil. Methods: the study sample included 26 participants. The first 13 laparotomies, and the first 13 laparoscopies performed at the bariatric surgery service of the institution were evaluated. The values evaluated in such comparison analyzed the costs of operation and hospitalization. It is important to highlight that, in addition to the cost benefit, other costs take significance in the health area, such as: cost-utility, cost-effectiveness and cost-minimization, in addition to the cost-opportunity that is reassessed in the observation of the broad context associating all the values raised here. The software used for data analysis was Excel version® 365. The economic analysis was performed evidencing the profile of the patients and the direct and indirect costs involved in each segmentation. Results: the direct and indirect costs of videolaparoscopy amounted to BRL 10,108.10 and laparoscopy to the amount of BRL 12,568.14. Conclusion: it was concluded that laparoscopy presents more savings in the aspects of all health valuations to the detriment of laparotomy. It was concluded that the videolaparoscopy presents more savings in the aspects of all health valuations than the laparotomy.

摘要：本文旨在通过对2017年至2020年间位于巴西南部除基本专业以外的医院，进行的首次开腹和腹腔镜减重手术的直接和间接成本进行临床经济性的回顾性横断面分析，以评估这些手术的主要成本。方法：研究样本包括26名参与者。对机构减重外科手术服务中前13次开腹手术和前13次腹腔镜手术进行了评估。比较分析中评估的值包括手术和住院成本。值得注意的是，除了成本效益之外，在卫生领域，其他成本也具有重要意义，例如成本效用、成本效益和成本最小化，以及在观察广泛背景时重新评估的成本机会成本。数据分析所使用的软件为Excel® 365版本。经济分析通过展示患者特征以及每个分段的直接和间接成本进行。结果：视频腹腔镜手术的直接和间接成本为10,108.10巴西雷亚尔，而腹腔镜手术的成本为12,568.14巴西雷亚尔。结论：研究表明，与开腹手术相比，腹腔镜手术在所有健康价值评估方面具有更高的成本节约。此外，研究表明，与开腹手术相比，视频腹腔镜手术在所有健康价值评估方面具有更高的成本节约。