title: Short- and long-term costs of laparoscopic colectomy are significantly less than open colectomy.
abstract: BACKGROUND
  The financial impact of laparoscopic colectomy remains poorly defined. We report the short-term costs of laparoscopic colectomy (LC) as compared with open colectomy (OC) in a high-volume tertiary care hospital, and are the first to incorporate the costs of late, colectomy-related complications in an analysis of long-term costs.
  
  
  METHODS
  A retrospective analysis of patients undergoing elective laparoscopic (n = 76) or open (n = 162) colon resection between January 2004 and December 2006 was performed. Primary endpoints were total hospital cost of the index admission and total hospital cost for any subsequent admission for treatment of a colectomy-related complication.
  
  
  RESULTS
  Two-hundred thirty-eight patients met inclusion criteria. Mean total hospital cost was significantly greater for patients undergoing OC (US $17,686 per patient versus US $14,518, P = 0.0003). Mean total operative costs were equivalent (US $7,451 OC versus US $7,794 LC, P = 0.274). Average length of stay was shorter for LC (5.2 versus 6.9 days, P < 0.0001). Late complication rates were 5.6% (OC) and 2.6% (LC). Integrating the cost of late complications further increased the disparity between the total cost of OC (US $18,296 per patient, 3.4% increase) as compared with LC (US $14,789, 1.9% increase).
  
  
  CONCLUSIONS
  We demonstrate both short- and long-term financial benefits of LC in a high-volume tertiary care hospital.
authors.affiliation: Division of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15261, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Eisenberg
authors.forename: Jane
authors.initials: J
authors.lastname: Wey
authors.forename: Philip Q
authors.initials: PQ
authors.lastname: Bao
authors.forename: Melissa
authors.initials: M
authors.lastname: Saul
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Watson
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Schraut
authors.forename: Kenneth K W
authors.initials: KK
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: James Moser
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hughes
mesh_terms: D016009:Chi-Square Distribution; D003082:Colectomy / Q000191:economics* / Q000379:methods*; D005260:Female; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics; D011183:Postoperative Complications / Q000191:economics; D012189:Retrospective Studies