INTRODUCTION: Recent studies have suggested that laparoscopic surgery for colorectal resection confers a cost benefit compared with open surgery. These studies have considered a wide range of colorectal operations together rather than focusing on a single procedure. Our study compared direct clinical costs for laparoscopic versus open right hemicolectomy. METHODS: Clinicopathological data and cost of treatment for all patients who underwent a right hemicolectomy between 2012 and 2013 were collected. The primary outcome was total cost of treatment. Secondary outcomes were length of stay, operative time and morbidity. The minimum follow-up duration was 12 months. Costs for laparoscopic and open surgery for elective resection alone were compared. Further analyses were performed comparing emergency cases with elective cases and cancer with non-cancer cases. RESULTS: There were 83 patients who underwent a right hemicolectomy during the study period and of these, 65 had an elective procedure. The total cost of a laparoscopic procedure was £3,998.12 compared with £3,427.50 for open surgery (p=0.039). The length of stay was shorter for laparoscopic surgery while the cost of an emergency right hemicolectomy was significantly greater than for elective surgery. CONCLUSIONS: Although the length of stay for laparoscopic surgery was shorter, this did not translate to a reduction in cost. The cost benefit from a shorter length of stay was offset by a greater cost of consumables. Cost effectiveness analyses should be designed carefully, and they should consider individual operations separately when making healthcare management and funding decisions.
INTRODUCTION: Recent studies have suggested that laparoscopic surgery for colorectal resection confers a cost benefit compared with open surgery. These studies have considered a wide range of colorectal operations together rather than focusing on a single procedure. Our study compared direct clinical costs for laparoscopic versus open right hemicolectomy. METHODS: Clinicopathological data and cost of treatment for all patients who underwent a right hemicolectomy between 2012 and 2013 were collected. The primary outcome was total cost of treatment. Secondary outcomes were length of stay, operative time and morbidity. The minimum follow-up duration was 12 months. Costs for laparoscopic and open surgery for elective resection alone were compared. Further analyses were performed comparing emergency cases with elective cases and cancer with non-cancer cases. RESULTS: There were 83 patients who underwent a right hemicolectomy during the study period and of these, 65 had an elective procedure. The total cost of a laparoscopic procedure was £3,998.12 compared with £3,427.50 for open surgery (p=0.039). The length of stay was shorter for laparoscopic surgery while the cost of an emergency right hemicolectomy was significantly greater than for elective surgery. CONCLUSIONS: Although the length of stay for laparoscopic surgery was shorter, this did not translate to a reduction in cost. The cost benefit from a shorter length of stay was offset by a greater cost of consumables. Cost effectiveness analyses should be designed carefully, and they should consider individual operations separately when making healthcare management and funding decisions.
Authors: Robert C G Martin; Nsehniitooh A Mbah; Randy St Hill; David Kooby; Sharon Weber; Charles R Scoggins; Shishir K Maithel Journal: World J Surg Date: 2015-06 Impact factor: 3.352
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: David G Jayne; Pierre J Guillou; Helen Thorpe; Philip Quirke; Joanne Copeland; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: J Clin Oncol Date: 2007-07-20 Impact factor: 44.544