Skip to main content
Top
Published in: World Journal of Surgery 1/2013

01-01-2013

Cost-comparison of Laparoscopic and Open Surgery for Mid or Low Rectal Cancer after Preoperative Chemoradiotherapy: Data from a Randomized Controlled Trial

Authors: Hae-Jung Son, Hoo-Yeon Lee, Ji Won Park, Hyo Seong Choi, Seung-Yong Jeong, Jae Hwan Oh

Published in: World Journal of Surgery | Issue 1/2013

Login to get access

Abstract

Background

The purpose of the present study was to compare the direct costs of laparoscopic surgery (LS) and open surgery (OS) in the treatment of mid or low rectal cancer after preoperative chemoradiotherapy in patients in Korea.

Methods and results

The records of 130 LS patients and 125 OS patients were reviewed. Hospital stay after surgery and overall complication rates within three months of surgery were not significantly different. The LS group had significantly higher median costs than the OS group ($7,467.30 vs. $5,667.00; P < 0.001). The median hospital costs during hospitalization for surgery were higher in the LS group ($7,436.60 vs. $5,626.60; P < 0.001), but hospital costs for management of early postoperative complications were similar. The higher direct costs of LS were mainly due to the more expensive consumables and equipment needed for LS.

Conclusions

Further study is needed to determine whether the higher direct costs of LS for rectal cancer are balanced by advantages of LS over OS, such as better short-term outcomes and cosmetic effect.
Literature
1.
go back to reference Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMed Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMed
2.
go back to reference Fowler DL, White SA (1991) Laparoscopic-assisted sigmoid resection. Surg Laparosc Endosc 1:183–188PubMed Fowler DL, White SA (1991) Laparoscopic-assisted sigmoid resection. Surg Laparosc Endosc 1:183–188PubMed
3.
go back to reference Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopy assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRef Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopy assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRef
4.
go back to reference Leung KL, Kwok SP, Lam SC et al (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomized trial. Lancet 363:1187–1192PubMedCrossRef Leung KL, Kwok SP, Lam SC et al (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomized trial. Lancet 363:1187–1192PubMedCrossRef
5.
go back to reference Clinical Outcomes of Surgical Therapy Study Group (COST) (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef Clinical Outcomes of Surgical Therapy Study Group (COST) (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
6.
go back to reference Colon Cancer Laparoscopic or Open Resection Study Group (COLOR) (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomized trial. Lancet Oncol 6:477–484CrossRef Colon Cancer Laparoscopic or Open Resection Study Group (COLOR) (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomized trial. Lancet Oncol 6:477–484CrossRef
7.
go back to reference Guillou PJ, Quirke P, Thorpe H et al (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC-CLASICC trial): multicentre, randomized controlled trial. Lancet 365:1718–1726PubMedCrossRef Guillou PJ, Quirke P, Thorpe H et al (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC-CLASICC trial): multicentre, randomized controlled trial. Lancet 365:1718–1726PubMedCrossRef
8.
go back to reference Zheng MH, Feng B, Lu AG et al (2005) Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma. World J Gastroenterol 11:232–326 Zheng MH, Feng B, Lu AG et al (2005) Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma. World J Gastroenterol 11:232–326
9.
go back to reference Jayne DG, Thorpe HC, Copeland J et al (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645PubMedCrossRef Jayne DG, Thorpe HC, Copeland J et al (2010) Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645PubMedCrossRef
10.
go back to reference Kang SB, Park JW, Jeong SY et al (2010) Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomized controlled trial. Lancet Oncol 11:637–645PubMedCrossRef Kang SB, Park JW, Jeong SY et al (2010) Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomized controlled trial. Lancet Oncol 11:637–645PubMedCrossRef
11.
go back to reference Delaney CP, Kiran RP, Senaqore AJ et al (2003) Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery. Ann Surg 238:67–72PubMed Delaney CP, Kiran RP, Senaqore AJ et al (2003) Case-matched comparison of clinical and financial outcome after laparoscopic or open colorectal surgery. Ann Surg 238:67–72PubMed
12.
go back to reference Braga M, Vignali A, Zuliani W et al (2005) Laparoscopic versus open colorectal surgery: cost-benefit analysis in a single-center randomized trial. Ann Surg 242:890–896PubMedCrossRef Braga M, Vignali A, Zuliani W et al (2005) Laparoscopic versus open colorectal surgery: cost-benefit analysis in a single-center randomized trial. Ann Surg 242:890–896PubMedCrossRef
13.
go back to reference Braga M, Frasson M, Vignali A et al (2007) Laparoscopic resection in rectal cancer patients: outcome and cost-benefit analysis. Dis Colon Rectum 50:464–471PubMedCrossRef Braga M, Frasson M, Vignali A et al (2007) Laparoscopic resection in rectal cancer patients: outcome and cost-benefit analysis. Dis Colon Rectum 50:464–471PubMedCrossRef
14.
go back to reference Janson M, Bjorholt I, Carlsson P et al (2004) Randomized clinical trial of the costs of open and laparoscopic surgery for colonic cancer. Br J Surg 91:409–417PubMedCrossRef Janson M, Bjorholt I, Carlsson P et al (2004) Randomized clinical trial of the costs of open and laparoscopic surgery for colonic cancer. Br J Surg 91:409–417PubMedCrossRef
15.
go back to reference Franks PJ, Bosanquet N, Thorpe H et al (2006) Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer 95:6–12PubMedCrossRef Franks PJ, Bosanquet N, Thorpe H et al (2006) Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer 95:6–12PubMedCrossRef
16.
go back to reference Ridgway PF, Boyle E, Keane FB et al (2007) Laparoscopic colectomy is cheaper than conventional open resection. Colorectal Dis 9:819–824PubMedCrossRef Ridgway PF, Boyle E, Keane FB et al (2007) Laparoscopic colectomy is cheaper than conventional open resection. Colorectal Dis 9:819–824PubMedCrossRef
18.
go back to reference Hyodo I, Suzuki H, Takahashi K et al (2010) Present status and perspectives of colorectal cancer in Asia: Colorectal Cancer Working Group report in 30th Asia-Pacific cancer conference. Jpn J Clin Oncol 40(Suppl 1):i38–i143PubMedCrossRef Hyodo I, Suzuki H, Takahashi K et al (2010) Present status and perspectives of colorectal cancer in Asia: Colorectal Cancer Working Group report in 30th Asia-Pacific cancer conference. Jpn J Clin Oncol 40(Suppl 1):i38–i143PubMedCrossRef
19.
go back to reference Choi YS, Lee SI, Lee TG et al (2007) Economic outcomes of laparoscopic versus open surgery for colorectal cancer. Surg Today 37:127–132PubMedCrossRef Choi YS, Lee SI, Lee TG et al (2007) Economic outcomes of laparoscopic versus open surgery for colorectal cancer. Surg Today 37:127–132PubMedCrossRef
Metadata
Title
Cost-comparison of Laparoscopic and Open Surgery for Mid or Low Rectal Cancer after Preoperative Chemoradiotherapy: Data from a Randomized Controlled Trial
Authors
Hae-Jung Son
Hoo-Yeon Lee
Ji Won Park
Hyo Seong Choi
Seung-Yong Jeong
Jae Hwan Oh
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 1/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-012-1783-x

Other articles of this Issue 1/2013

World Journal of Surgery 1/2013 Go to the issue