Laparoscopic Nissen fundoplication is more cost-effective than open Nissen fundoplication in children
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In brief
In brief
This retrospective study of 32 pediatric patients demonstrates that laparoscopic Nissen fundoplication offers significant advantages over open surgery, including 39% lower costs, reduced hospital stays, and decreased postoperative pain medication requirements, with comparable complication rates and outcomes.
- Laparoscopic Nissen fundoplication reduces operating time by 51 minutes compared to open approach in pediatric patients (165 vs 217 min).
- Laparoscopic approach cuts postoperative hospital stay by more than half (3.8 vs 8.1 days) with reduced morphine requirements.
- Total cost per case is 39% lower with laparoscopic technique (261 vs 427 kSEK) without increased complication rates.
- Laparoscopic Nissen fundoplication is the preferred cost-effective approach for pediatric GERD surgery with superior recovery metrics.
Written by the GCMD Library team from the article.
Abstract
Background
Nissen fundoplication is one of the most common surgical procedures for gastroesophageal reflux. Current and previous research comparing laparoscopic Nissen fundoplication (LNF) versus open Nissen fundoplication (ONF) in children suggest ambiguous conclusions. The purpose of this retrospective study was to compare the outcome for children operated with LNF or ONF at our institution and to evaluate the economic aspects.
Methods
32 consecutive patients (LNF: n = 18, ONF: n = 14) operated with Nissen fundoplication between the years 2011–2017 were included in the study. Data was collected by examination of the patient journals and preoperative, operative, postoperative, and post-discharge parameters were analyzed.
Results
Compared to ONF, the LNF group had shorter operating time (165.2 vs 216.6 min, p < 0.05), shorter overall operating room duration (315.0 vs 334.9 min, p < 0.05) and shorter postoperative hospital stay (3.8 vs 8.1 days, p < 0.05). The LNF group also required less morphine (1.2 vs 1.7 mg/kg, p < 0.05) and the total cost per case was 39% lower (261.1 vs 427.4 kSEK, p < 0.05). No difference was seen in postoperative complications and results.
Conclusion
Laparoscopic Nissen fundoplication is more cost-effective compared to open surgery and reduces postoperative hospital stay and morphine requirements.