title: Single center cost analysis of single-port and conventional laparoscopic surgical treatment in colorectal malignant diseases.
abstract: OBJECTIVE
  Single-port laparoscopy (SPL) is a relatively new technique, used in various procedures. There is limited knowledge about the cost effectiveness and the learning curve of this technique. The primary aim of this study was to compare hospital costs between SPL and conventional laparoscopic resections (CLR) for colorectal cancer; the secondary aim was to identify a learning curve of SPL.
  
  
  METHODS
  All elective colorectal cancer SPL and CLR performed in a major teaching hospital between 2011 and 2012 that were registered in the Dutch Surgical Colorectal Audit were included (n = 267). The economic evaluation was conducted from a hospital perspective, and costs were calculated using time-driven activity-based costing methodology up to 90 days after discharge. When looking at SPL only, the introduction year (2011) was compared to the next year (2012).
  
  
  RESULTS
  SPL (n = 78) was associated with lower mortality, lower reintervention rates, and more complications as compared to CLR (n = 189); however, none of these differences were statistically significant. A significant shorter operating time was seen in the SPL. Total costs were higher for SPL group as compared to CLR; however, this difference was not statistically significant. For the SPL group, most clinical outcomes improved between 2011 and 2012; moreover, total hospital costs for SPL in 2012 became comparable to CLR.
  
  
  CONCLUSIONS
  No significant differences in financial outcomes between SPL and CLR were identified. After the introduction period, SPL showed similar results as compared to CLR. Conclusions are based on a small single-port group and the conclusions of this manuscript should be an impetus for further research.
authors: Department of General Surgery Resident, Jeroen Bosch Hospital, P.O. Box 90153, 5200 ME, 's Hertogenbosch, The Netherlands. yoenvanderlinden@gmail.com.|Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. yoenvanderlinden@gmail.com.
authors: Yoen T K
authors: YT
authors: van der Linden
authors: Department of Surgery, Groene Hart Ziekenhuis, Gouda, The Netherlands.|Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors: Johannes A
authors: JA
authors: Govaert
authors: Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, The Netherlands.|Leiden University Mathematical Institute, Leiden, The Netherlands.
authors: Marta
authors: M
authors: Fiocco
authors: Performation, Bilthoven, The Netherlands.|X-IS, Delft, The Netherlands.
authors: Wouter A
authors: WA
authors: van Dijk
authors: Department of General Surgery Resident, Jeroen Bosch Hospital, P.O. Box 90153, 5200 ME, 's Hertogenbosch, The Netherlands.
authors: Daniel J
authors: DJ
authors: Lips
authors: Department of General Surgery Resident, Jeroen Bosch Hospital, P.O. Box 90153, 5200 ME, 's Hertogenbosch, The Netherlands.
authors: Hubert A
authors: HA
authors: Prins
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000191:economics* / Q000601:surgery*; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D059032:Learning Curve; D007902:Length of Stay / Q000191:economics; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal cancer surgery; Cost analysis; Laparoscopic surgery; Single-port laparoscopy