Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial)

Abstract

The short-term clinical results of the CLASICC trial indicated that clinical outcomes were similar between laparoscopic and open approaches. This study presents the short-term (3 month) cost analysis undertaken on a subset of patients entered into the CLASICC trial (682 of 794 patients). As expected the costs associated with the operation were higher in the 452 patients randomised to laparoscopic surgery (lap) compared with the 230 randomised to open procedure (open), d1703 vs d1386. This was partially offset by the other hospital (nontheatre) costs, which were lower in the lap group (d2930 vs d3176). The average cost to individuals for reoperations was higher in the lap group (d762 vs d553). Overall costs were slightly higher in the lap group (d6899 vs d6631), with mean difference of d268 (95%CI À689 to 1457). Sensitivity analysis made little difference to these results. The cost of rectal surgery was higher than for colon, for lap (d8259 vs d5586) and open procedures (d7820 vs d5503). The short-term cost analysis for the CLASICC trial indicates that the costs of either laparoscopic or open procedure were similar, lap surgery costing marginally more on average than open surgery.

Short- and long-term costs of laparoscopic colectomy are significantly less than open colectomy

“…While the majority of these are small, retrospective cohort series, several prospective, randomized controlled trials have been performed. A cost analysis on a subset of 682 patients from the Conventional versus LaparoscopicAssisted Surgery in Colorectal Cancer (CLASICC) trial was recently reported [23]. All colectomies were performed for colorectal cancer.…”

Single-Port Laparoscopic Right Hemicolectomy: A Safe Alternative to Conventional Laparoscopy

“…In general, the initial operative costs associated with the laparoscopic technique are mitigated by reductions in morbidity and duration of hospital stay in the minimally invasive approach. 27 One particular concern in single-port access is that it will require purchase of proprietary instrumentation and increase operative costs. In this series, the access port allows the use of existing laparoscopic instrumentation, and no new instruments or optics are necessary.…”

Laparoscopically assisted colectomy: a study of risk factors and predictors of open conversion

“…In addition, the intra-and postoperative complication rates are low and acceptable compared with those for open surgery [4]. The results of short-term follow-up studies have shown that the overall costs are similar for laparoscopic and open colectomy [7] despite an initial greater operative cost [8]. The drawbacks of laparoscopic colectomy are the longer duration of the procedure [3,4] and the long learning curve for surgeons in training [9][10][11].…”