Is laparoscopic colectomy as cost beneficial as open colectomy?
BACKGROUND
Laparoscopic colectomy has yet to gain widespread acceptance in cost-conscious health-care institutions. The aim of the present study was to define the cost-benefit relationship of laparoscopic versus open colectomy.


METHODS
Thirty-two consecutive patients undergoing elective laparoscopic colectomy (LC) by a single colorectal surgeon between August 2004 and September 2005 were reviewed. Cases were matched with a historical cohort undergoing elective open colectomy (OC) between June 2003 and July 2004. Demography, perioperative data, histopathology and cost were compared.


RESULTS
Both groups had similar demographics. Most resections (90.6%) were for cancer. Operative time was significantly longer for LC compared to OC (180 min vs 110 min, P < 0.001). Four patients (12.5%) in the LC group required conversion. LC patients, however, had lower median pain scores (3, 2 and 1 vs 6, 4 and 2 at 24, 48 and 72 h postoperatively, P < 0.001), faster resolution of ileus (3 vs 4 days, P < 0.001) and earlier discharge (6 vs 9 days, P < 0.001) compared to the OC group. As a result, overall hospital cost for both procedures was not significantly different (US$7943 vs US$7253, P = 0.41).


CONCLUSIONS
Laparoscopic colectomy is as cost-beneficial in the short term as open colectomy.
Division of Colorectal Surgery, Department of Surgery, National University Hospital, Singapore, Singapore.
Asim
A
Shabbir
April C
AC
Roslani
Kutt-Sing
KS
Wong
Charles B S
CB
Tsang
Hwee-Bee
HB
Wong
Wai-Kit
WK
Cheong
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000191:economics*; D003110:Colonic Neoplasms / Q000601:surgery*; D003362:Cost-Benefit Analysis; D043963:Diverticulosis, Colonic / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged