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Menon A, Shapey I, Nicholson J, Muhammad KB, Solkar M, Siddiqui KH PowerPoint Presentation
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Cost comparison of Laparoscopic versus Open Colorectal Resections in a district general hospital setting. Menon A, Shapey I, Nicholson J, Muhammad KB, Solkar M, Siddiqui KH. Department of General Surgery, Tameside General Hospital, Ashton-Under-Lyne, UK. Introduction. Patients & Methods.

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Cost comparison of Laparoscopic versus Open Colorectal Resections in a district general hospital setting

Menon A, Shapey I, Nicholson J, Muhammad KB, Solkar M, Siddiqui KH

Department of General Surgery, Tameside General Hospital, Ashton-Under-Lyne, UK

Introduction

Patients & Methods

  • Laparoscopic colorectal resection has been associated with improved patient outcomes including postoperative pain (1,2), length of hospital stay (1,2), and return to normal activities (3).
  • . However, there remains a perception that there is a financial cost to instituting a laparoscopic program due to equipment costs.
  • The authors contend that this cost is more than offset by reductions in the length of hospitalisation.
  • A laparoscopic colorectal resection program was instituted at Tameside General Hospital in July 2009, and this study aims to compare the financial costs of laparoscopic versus open colorectal resectional surgery during this period.
  • Retrospective analysis of all open and laparoscopic colorectal resections performed between July 2009 and July 2011.
  • All cases performed by 3 surgeons (KHS, MS, KBM).
  • The primary endpoints of this study were:
  • 1. Length of hospital stay (LOS) in days
  • 2. Total costs per patient (CPP) in UK Pounds (£)
  • CPP comprises total operative, inpatient stay, critical care, and readmission costs.
  • 2-tailed student t-tests and chi-squared tests were performed to ascertain differences between the 2 groups.

Results

1. Demographics and 30 Day Outcomes

3. Median Costs per Patient

£

5 mm

*Significance at 95% confidence

2. Median Length of Stay

DAYS

*Significance at 95% confidence

Significant reductions in median length of stay with laparoscopic resections

No significant differences in median costs per patient between open and laparoscopic resection

EXCEPT Laparoscopic Right hemicolectomy which is significantly cheaper than open

References

Conclusions

1. Schwenk W et al. Short term benefits for laparoscopic colorectal resection. Short term benefits for laparoscopic colorectal resection. CochraneDatabaseSyst Rev. 2005 Jul 20;(3):CD003145.

2. Abraham NS et al. Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg. 2004 Sep;91(9):1111-24.

3. Hayes JL et al. Is laparoscopic colectomy for cancer cost-effective relative to open colectomy? ANZJ Surg. 2007 Sep;77(9):782-6.

Increased operative costs in the laparoscopic group were offset by significant reductions in length of stay.

These results suggest that a laparoscopic service can be instituted without adverse financial consequences.