Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov 19:5:23-8.
doi: 10.1016/j.amsu.2015.11.005. eCollection 2016 Feb.

A cost-minimization analysis of first intention laparoscopic compared to open right hemicolectomy for colon cancer

Adam L Widdison  1 , Victoria Barns  1 , Oliver Prescott  1 , Adam Pollard  1
Affiliations

A cost-minimization analysis of first intention laparoscopic compared to open right hemicolectomy for colon cancer

Adam L Widdison et al. Ann Med Surg (Lond). .

Abstract

Background: The morbidity, mortality and survival following a laparoscopic right hemicolectomy for colon cancer are equivalent to an open operation. However, the cost of a longer operating time and consumables may offset savings from a shorter length of stay (LOS). A cost minimization study was undertaken to compare the relative costs.

Methods: A retrospective cohort study of consecutive elective right hemicolectomies for colon cancer performed over 5 years by two teams. One team performed an open operation (OG), the other intended to perform all operations laparoscopically (LG). Clinical outcomes and relative costs were evaluated. Results expressed as mean ± SEM.

Results: There were 58 patients in the open group and 56 in the first intention laparoscopic group, of which 77% were completed laparoscopically. There was no difference in age, gender or cancer stage. The complications, mortality and 5-year survival were similar. Anaesthetic (LG = 63 ± 3, OG = 62 ± 2 min) and surgical times (LG = 144 ± 8, OG = 143 ± 5 min) were similar. Consumables cost €571 more and the total theatre cost was €643 ± 256 higher in the laparoscopic group compared with the open group (p = 0.01). The LOS in the laparoscopic group (4.6 ± 0.5 days) was less than in the open group (8.3 ± 1 days, p < 0.01) saving €1960 ± 636 per patient. Overall, first intention laparoscopic right hemicolectomies saved €1316 ± 733 per patient. A probability sensitivity analysis indicated a 62% probability that a laparoscopic right hemicolectomy was cheaper than an open operation.

Conclusion: Laparoscopic right hemicolectomy is oncologically equivalent but less costly and should be considered the procedure of choice for right-sided colon cancer unless contraindicated.

Keywords: Colon cancer; Cost minimisation; Minimally invasive surgery; Right hemicolectomy; Survival.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
The cumulative probability that the relative cost of first intention laparascopic right hemicolectomy is less than an open procedure.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cancer research UK. UK bowel cancer Statistics. http://www.cancerresearchuk.org/health-professional/cancer-statistics/st.... Accessed 1st July 2015.
    1. Ding J., Liao G.Q., Xia Y., Zhang Z.M., Liu S., Yan Z.S. Laparoscopic versus open right hemicolectomy for colon cancer: a Meta analysis. J. Laparoendosc. Adv. Surg. Tech. 2013;23(1):8–16. - PubMed
    1. Rondelli F., Trastulli S., Avenia N., Schillaci G., Cirochchi R., Gulia N., Mariani E., Bistoni G., Noya G. 2013. Is Laparoscopic Right Hemicolectomy More Effective than Open Resection? A Meta Analysis of Randomized and Nonrandomized Studies.http://dx.doi.org/10.1111/j Accessed 20 September 2013. - DOI - PubMed
    1. Green B.L., Marshall H.C., Collinson F., Quirke P., Guillou P., Jayne D.G., Brown J.M. Long-term follow up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br. J. Surg. 2013;100:75–82. - PubMed
    1. Zhao Li-Ying, Chi Pan, Ding Wei-Xing, Huang Shun-Rong, Zhang Si-Fen, Pan Kai, Hu Yan-Feng, Liu Hao, Li Guo-Xin. Laparoscopic vs open extended right hemicolectomy for colon cancer. World J. Gastroenterol. 2014;20(24):7926–7932. - PMC - PubMed