Surgery Today

, Volume 48, Issue 4, pp 439–448 | Cite as

Assessing the economic advantage of laparoscopic vs. open approaches for colorectal cancer by a propensity score matching analysis

  • Hiromitsu Hayashi
  • Nobuyuki Ozaki
  • Katsuhiro Ogawa
  • Yoshiaki Ikuta
  • Hideyuki Tanaka
  • Kenichi Ogata
  • Koichi Doi
  • Hiroshi Takamori
Original Article



This study investigated the surgical outcomes and potential economic advantage of open vs. laparoscopic surgery for colorectal cancer using a propensity score matching analysis.


We examined the surgical and economic outcomes of patients undergoing laparoscopic (N = 127) and open surgery (N = 253) for colorectal cancer and then compared these outcomes in two groups (N = 103 each) using a propensity score matching analysis.


Compared to open surgery, the laparoscopic approach was associated with a significantly lower overall morbidity rate (14 vs. 40%; P < 0.001) and shorter mean (± standard deviation) postoperative hospital stay (12.6 ± 8.3 vs. 16.8 ± 9.9 days, respectively; P = 0.001). Despite generating higher mean surgical costs (Japanese yen) (985,000 ± 215,000 vs. 812,000 ± 222,000 yen; P < 0.001), utilizing a laparoscopic approach significantly reduced the non-surgical costs (773,000 ± 440,000 vs. 1075,000 ± 508,000 yen; P < 0.001). The mean total cost of laparoscopic-assisted surgery (1758,000 ± 576,000 yen) was decreased by approximately 130,000 yen compared with open surgery (1886,000 ± 619,000 yen), although the difference was not statistically significant (P = 0.125).


Laparoscopic surgery for colorectal cancer is advantageous in reducing morbidity and facilitating an early discharge and does not increase hospital costs. These findings are consistent with the general consensus supporting the benefits of laparoscopic surgery as a minimally invasive approach.


Laparoscopic colectomy Colorectal cancer Economic benefit 



Japan Nosocomial Infections Surveillance


National Nosocomial Infection Surveillance System


Surgical site infection


Physical status classification system


Body surface area


Body mass index



The authors thank Taisuke Yagi and Naoki Umesaki for their valuable clinical assistance with this study.

Conflict of interest

Hiromitsu Hayashi and the co-authors have no conflicts of interest.

Financial support


Supplementary material

595_2017_1606_MOESM1_ESM.doc (40 kb)
Supplementary material 1 (DOC 40 kb)


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Copyright information

© Springer Japan KK, part of Springer Nature 2017

Authors and Affiliations

  • Hiromitsu Hayashi
    • 1
  • Nobuyuki Ozaki
    • 1
  • Katsuhiro Ogawa
    • 1
  • Yoshiaki Ikuta
    • 1
  • Hideyuki Tanaka
    • 1
  • Kenichi Ogata
    • 1
  • Koichi Doi
    • 1
  • Hiroshi Takamori
    • 1
  1. 1.Department of SurgerySaiseikai Kumamoto Hospital, Imperial Gift Foundation IncKumamotoJapan

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