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Lookup NU author(s): Alan Horgan
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Background: We aimed to assess the clinical outcomes and costs associated with laparoscopic resection within an elective colorectal practice. Method: Over a 12-month period data were prospectively collected on patients undergoing elective colorectal resection under the care of a single consultant surgeon. Thirty patients undergoing laparoscopic colorectal resection were case-matched by type of resection, disease process, and, where appropriate, cancer stage to patients having open surgery. A cost analysis was carried out incorporating cost of surgical bed stay, theater time, and specific equipment costs. Results: In the 30 patients having laparoscopic resection, a conversion rate of 13% was observed. Surgery was performed for colorectal cancer in 83% of patients, and 53% of resections were rectal. No significant differences were found in age (65 versus 69 years, p = 0.415), BMI (27.4 versus 26.1, p = 0.527), POSSUM physiology score (16 versus 16.5, p = 0. 102), American Society of Anesthesiologists (ASA) grade (2 versus 2, p = 0.171), or length of theater time (160 min versus 160 min, p = 0.233) between the laparoscopic and open patients. Hospital stay was reduced in the laparoscopic group (5 versus 9 days, p < 0.001). Average cost of surgical equipment used for a laparoscopic resection was greater than for open surgery (912.39 pound versus 276.41 pound, p = 0.001). Cost of hospital stay was significantly less (1259.75 pound versus 2267.55 pound, p < 0.001). Cost of operating room time was similar for the two groups (2066.63 pound versus 1945.07 pound, p = 0. 152). Overall no significant cost difference could be found between open and laparoscopic resection (4560.9 pound versus 4348.45 pound, p = 0.976). More postoperative complications were seen in the open resection group (14 versus 4, p < 0.001). Conclusions: Intraoperative equipment costs are greater for laparoscopic resection than for open surgery. However, benefits can be seen in terms of quicker recovery and shorter hospital stay. Laparoscopic surgery is a financially viable alternative to open resection in selected patients.
Author(s): Noblett SE, Horgan AF
Publication type: Article
Publication status: Published
Journal: Surgical Endoscopy
ISSN (print): 0930-2794
ISSN (electronic): 1432-2218
Publisher: Springer New York LLC
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