ORIGINAL CONTRIBUTION
Cost-effectiveness of Laparoscopy in Rectal Cancer Deborah S. Keller, M.S., M.D. • Bradley J. Champagne, M.D. Harry L. Reynolds, Jr., M.D. • Sharon L. Stein, M.D. Conor P. Delaney, M.D., M.Ch., Ph.D., F.R.C.S.I. Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio
BACKGROUND: There is an increasing trend to use laparoscopy for rectal cancer surgery. Although laparoscopic and open rectal resections appear oncologically equivalent, there is little information on the cost of different surgical approaches. With the current health care crisis and the importance of optimizing health care resources and patient outcomes, the cost of care is an important factor. OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of laparoscopy in rectal cancer. DESIGN: This was a case-matched study. SETTINGS: This study was conducted at a tertiary referral
center. PATIENTS: Patients undergoing elective rectal cancer resection between 2007 and 2012 were selected. METHODS: A review of a prospective database for elective
laparoscopic rectal cancer resections was performed. Laparoscopic cases were matched to open cases based on age, BMI, operative procedure, and diagnostic-related group. MAIN OUTCOME MEASURES: The primary outcomes measured were the cost of care, hospital length of stay, discharge disposition, readmission, postoperative complications, and mortality rates. RESULTS: Two hundred fifty-four matched cases were included in the analysis: 125 laparoscopic (49%) and Financial Disclosure: None reported. Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Phoenix, AZ, April 27 to May 1, 2013. Correspondence: Conor P. Delaney, M.D., M.Ch., Ph.D., F.R.C.S.I., Division of Colorectal Surgery, Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106–5047. E-mail: [email protected] Dis Colon Rectum 2014; 57: 564–569 DOI: 10.1097/DCR.0b013e3182a73244 © The ASCRS 2014
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129 open (51%). The cTNM stage (p = 0.39), tumor distance from the anal verge (p = 0.07), and rate of neoadjuvant therapy received between the laparoscopic and open groups were similar (p = 0.12). Operating time (p
Cost-effectiveness of Laparoscopy in Rectal Cancer Deborah S. Keller, M.S., M.D. • Bradley J. Champagne, M.D. Harry L. Reynolds, Jr., M.D. • Sharon L. Stein, M.D. Conor P. Delaney, M.D., M.Ch., Ph.D., F.R.C.S.I. Division of Colorectal Surgery, Department of Surgery, University Hospitals-Case Medical Center, Cleveland, Ohio
BACKGROUND: There is an increasing trend to use laparoscopy for rectal cancer surgery. Although laparoscopic and open rectal resections appear oncologically equivalent, there is little information on the cost of different surgical approaches. With the current health care crisis and the importance of optimizing health care resources and patient outcomes, the cost of care is an important factor. OBJECTIVE: The aim of this study was to evaluate the cost-effectiveness of laparoscopy in rectal cancer. DESIGN: This was a case-matched study. SETTINGS: This study was conducted at a tertiary referral
center. PATIENTS: Patients undergoing elective rectal cancer resection between 2007 and 2012 were selected. METHODS: A review of a prospective database for elective
laparoscopic rectal cancer resections was performed. Laparoscopic cases were matched to open cases based on age, BMI, operative procedure, and diagnostic-related group. MAIN OUTCOME MEASURES: The primary outcomes measured were the cost of care, hospital length of stay, discharge disposition, readmission, postoperative complications, and mortality rates. RESULTS: Two hundred fifty-four matched cases were included in the analysis: 125 laparoscopic (49%) and Financial Disclosure: None reported. Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Phoenix, AZ, April 27 to May 1, 2013. Correspondence: Conor P. Delaney, M.D., M.Ch., Ph.D., F.R.C.S.I., Division of Colorectal Surgery, Department of Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106–5047. E-mail: [email protected] Dis Colon Rectum 2014; 57: 564–569 DOI: 10.1097/DCR.0b013e3182a73244 © The ASCRS 2014
564
129 open (51%). The cTNM stage (p = 0.39), tumor distance from the anal verge (p = 0.07), and rate of neoadjuvant therapy received between the laparoscopic and open groups were similar (p = 0.12). Operating time (p
