title: Surgical cost of care in Crohn's disease.
abstract: The aim of the study was to evaluate the cost of surgical care and short-term outcomes of Crohn's disease(CD) in the era of laparoscopy and biologic therapy.
  
  
  METHODS
  Review of a prospective database identified CD patients that underwent surgical management. Patients were stratified into laparoscopic, open, and converted approaches. Main outcome measures were short-term patient outcomes and cost of care by approach.
  
  
  RESULTS
  92 patients were analyzed- 63.1% laparoscopic, 32.6% open, 4.3% converted. The majority was elective (100% converted, 94.8% laparoscopic, 90% open) and segmental resections (75% converted, 70.7% laparoscopic, 43.3% open). Operative times were similar between laparoscopic and open (152 minutes and 138 minutes, respectively). More open patients required ICU care (20% versus 12.1% laparoscopic and 0% converted). The median LOS was 3 (1-25) days laparoscopic, 4 (1-29) open and 4 (3-8) converted. The laparoscopic complication rate was 15.5%, readmission rate 12.1%, and reoperation rate 8.6%. The mean total hospital cost was $9,702 laparoscopic, $10,782 open, and $13,293 for converted cases (US Dollars).
  
  
  CONCLUSIONS
  Laparoscopy is appropriate for most CD cases. When necessary to combine with open surgery, this results in efficient and effective patient outcomes and healthcare utilization. These results are important when weighing the cost of ongoing medical therapy versus surgical intervention.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Keller
authors.forename: Jeffry
authors.initials: J
authors.lastname: Katz
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Stein
authors.forename: Conor P
authors.initials: CP
authors.lastname: Delaney
mesh_terms: D000328:Adult; D003107:Colorectal Surgery / Q000191:economics*; D017281:Cost of Illness; D003424:Crohn Disease / Q000191:economics* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011044:Poland; D011446:Prospective Studies