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Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass

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  • Samanta Pereira Sussenbach
  • Everton Nunes Silva
  • Milene Amarante Pufal
  • Daniela Shan Casagrande
  • Alexandre Vontobel Padoin
  • Cláudio Corá Mottin

Abstract

Background: Because of the high prevalence of obesity, there is a growing demand for bariatric surgery worldwide. The objective of this systematic review was to analyze the difference in relation to cost-effectiveness of access route by laparoscopy versus laparotomy of Roux en-Y gastric bypass (RYGB). Methods: A systematic review was conducted in the electronic databases MEDLINE, Embase, Scopus, Cochrane and Lilacs in order to identify economic evaluation studies that compare the cost-effectiveness of laparoscopic and laparotomic routes in RYGB. Results: In a total of 494 articles, only 6 fulfilled the eligibility criteria. All studies were published between 2001 and 2008 in the United States (USA). Three studies fulfilled less than half of the items that evaluated the results quality; two satisfied 5 of the required items, and only 1 study fulfilled 7 of 10 items. The economic evaluation of studies alternated between cost-effectiveness and cost-consequence. Five studies considered the surgery by laparoscopy the dominant strategy, because it showed greater clinical benefit (less probability of post-surgical complications, less hospitalization time) and lower total cost. Conclusion: This review indicates that laparoscopy is a safe and well-tolerated technique, despite the costs of surgery being higher when compared with laparotomy. However, the additional costs are compensated by the lower probability of complications after surgery and, consequently, avoiding their costs.

Suggested Citation

  • Samanta Pereira Sussenbach & Everton Nunes Silva & Milene Amarante Pufal & Daniela Shan Casagrande & Alexandre Vontobel Padoin & Cláudio Corá Mottin, 2014. "Systematic Review of Economic Evaluation of Laparotomy versus Laparoscopy for Patients Submitted to Roux-en-Y Gastric Bypass," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0099976
    DOI: 10.1371/journal.pone.0099976
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
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    1. Rodrigo Luiz Carregaro & Everton Nunes Silva & Maurits van Tulder, 2019. "Direct healthcare costs of spinal disorders in Brazil," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(6), pages 965-974, July.

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