Background: A retrospective cost-effectiveness analysis was carried out, comparing retroperitoneal endoscopic and conventional adrenalectomy, which is based on a large group of patients, restricted in tumor size for the purpose of ensuring comparability.
Materials and methods: Between 1990 and 2004, 61 patients underwent either an endoscopic or open adrenalectomy for tumors smaller than 6 cm. A short-term, base cost-effectiveness analysis was performed to evaluate costs per day prevented, and a sensitivity analysis was calculated.
Results: Average recovery time, postoperative stay, and resumption to oral intake were significantly shorter in the endoscopic group, whereas operative time was longer. No major complications occurred in either group. In 3 endoscopic procedures conversion was indicated. The base cost-effectiveness ratio was 15.41 per day postoperative stay prevented by the endoscopic approach. The number needed to treat with endoscopic adrenalectomy to prevent 1 week of postoperative stay is 2.
Conclusion: Retroperitoneal endoscopic adrenalectomy may be considered a cost-effective procedure, compared to the conventional open adrenalectomy.