Cost savings for elective laparoscopic resection compared with open resection for colorectal cancer in a region of high uptake

Thompson, Bridie S., Coory, Michael D., Gordon, Louisa G. and Lumley, John W. (2014) Cost savings for elective laparoscopic resection compared with open resection for colorectal cancer in a region of high uptake. Surgical Endoscopy, 28 5: 1515-1521. doi:10.1007/s00464-013-3345-1

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Author Thompson, Bridie S.
Coory, Michael D.
Gordon, Louisa G.
Lumley, John W.
Title Cost savings for elective laparoscopic resection compared with open resection for colorectal cancer in a region of high uptake
Journal name Surgical Endoscopy   Check publisher's open access policy
ISSN 0930-2794
1432-2218
Publication date 2014-05-01
Year available 2013
Sub-type Article (original research)
DOI 10.1007/s00464-013-3345-1
Open Access Status Not Open Access
Volume 28
Issue 5
Start page 1515
End page 1521
Total pages 7
Place of publication New York, NY, United States
Publisher Springer
Language eng
Formatted abstract
Background: Previous cost analyses of laparoscopic resection for colorectal cancer (CRC) reported slightly higher or similar costs to those of open resection. These analyses were based on randomised controlled trials when the laparoscopic approach was newly adopted. This study compared costs for laparoscopic versus open resection in a region of high uptake where adoption is mature.

Methods: 
Hospital cost data were obtained for elective resections for CRC that occurred between June 2009 and June 2011 in public hospitals in Queensland, Australia. The primary outcome was total cost and secondary outcomes were length-of-stay, operating time, and ICU admission. Multivariate least-squares regression was used to adjust for potential confounders: age, sex, comorbidities, procedure, and hospital volume.

Results: The crude mean cost for laparoscopic resection was €20,036 compared with that for open resection of €22,780 (difference = €2,744). Patients who underwent laparoscopic resection (744/1,397; 53 %) were slightly younger and had fewer comorbidities (decreasing costs) but more had rectal surgery (increasing costs). The adjusted mean cost for laparoscopic resection was €20,396 compared with €22,442 for open resection (difference = €2,054). Compared with open resection, when adjusted for potential confounders, laparoscopic resection resulted in similar operating time (216 vs. 214 min), shorter length-of-stay (difference = −1.1 days, 95 % CI −1.9, −0.3), and shorter admission to ICU (difference = −7.3 h, 95 % CI −11.9, −2.7).

Conclusions: This non-randomised study in a region of high uptake found a similar operating time and lower cost for laparoscopic resection for CRC compared with those of open resection due to a shorter length-of-stay and shorter time in ICU. Laparoscopic resection for CRC saves money when the procedure is widely adopted and surgeons are experienced in the technique.
Keyword Colorectal cancer
Laparoscopic resection
Cost comparison
Population-based data
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 14 December 2013.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 18 Dec 2013, 03:01:10 EST by Dr Anna D MacDonald (nee Holmes) on behalf of School of Public Health