Laparoscopic versus open colorectal surgery: Cost-benefit analysis in a single-center randomized trial

Marco Braga, Andrea Vignali, Walter Zuliani, Matteo Frasson, Clelia Di Serio, Valeria Di Carlo, [No Value] Haglund, [No Value] Jeekel, [No Value] Senninger, [No Value] Heberer

Research output: Contribution to journalArticle

Abstract

Background Data: Studies comparing the costs of colorectal resection by laparoscopic (LPS) and open approaches are small sized or not randomized. The main purpose of this study is to compare the hospital costs of LPS and open colorectal surgery in a large series of randomized patients. Methods: A total of 517 patients with colorectal disease were randomly assigned to LPS (n = 258) or open (n = 259) resection. The following costs were calculated: surgical instruments, operative room (OR) occupation, routine care, postoperative morbidity, and length of hospital stay (LOS). Follow-up for postoperative morbidity was carried out for 30 days after hospital discharge. Results: Operative time was 37 minutes longer in the LPS group. Overall morbidity rate was 18.2% (47 of 258) in the LPS versus 34.7% (90 of 259) in the open group (P = 0.0005). The mean LOS was 9.9 (2.6) days in the LPS group and 12.4 (3.9) days in the open group (P <0.0001). The additional OR charge in the LPS group was €1171 per patient randomized (€864 due to surgical instruments and €307 due to longer time). The saving in the LPS group was €1046 per patient randomized (€401 due to shorter LOS and €645 due to the lower cost of postoperative complications). The net balance resulted in €125 extra cost per patient allocated to the LPS group. Conclusions: The present cost-benefit analysis showed a slight additional cost in the LPS group. The better postoperative short-term outcome in patients receiving LPS had a key role to nearly balance the operative room charges due to laparoscopy.

Original languageEnglish
Pages (from-to)890-896
Number of pages7
JournalAnnals of Surgery
Volume242
Issue number6
DOIs
Publication statusPublished - Dec 2005

ASJC Scopus subject areas

  • Surgery

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    Braga, M., Vignali, A., Zuliani, W., Frasson, M., Di Serio, C., Di Carlo, V., Haglund, N. V., Jeekel, N. V., Senninger, N. V., & Heberer, N. V. (2005). Laparoscopic versus open colorectal surgery: Cost-benefit analysis in a single-center randomized trial. Annals of Surgery, 242(6), 890-896. https://doi.org/10.1097/01.sla.0000189573.23744.59