Abstract
The aim of this study was to estimate and compare the costs of open right hemicolectomy (ORHC) versus laparoscopically assisted right hemicolectomy (LARHC) performed for cancer. A retrospective cost analysis of 61 consecutive patients operated on between January 1992 and August 1994 for right-sided colonic cancer by either LARHC (n = 28) or ORHC (n = 33) was performed. The analysis focused on the cost (in Australian dollars) incurred from the date of operation to the date of discharge. LARHC was significantly more expensive than ORHC (total cost LARHC $9064, ORHC $7881; p < 0.001). LARHC was associated with a significantly longer operating room utilization time (LARHC 261 minutes, ORHC 203 minutes; p < 0.001) and a greater cost of disposables (LARHC $854, ORHC $189; p < 0.001). This study demonstrates no cost benefit for LARHC compared to ORHC when performed for cancer.
Résumé
Le but de cette étude a été d’évaluer et de comparer les coûts de la colectomie droite effectuée par laparoscopie de celle réaliséc de façon traditionnelle. On a ainsi étudié une série de 61 patients consécutifs opérés entre Janvier 1992 et Août 1994 pour un cancer du colon droit soit par laparoscopie assistée (LARHC, n = 28) soit de façon traditionnelle (ORHC, n = 33). L’analyse était centrée sur les coûts (en dollars australiens [$ Au]) à partir de la date de l’opération jusqu’à la date de la sortie. Les coûts de la LARHC étaient significativement plus élevés que ceux de l’ORHC (coûts totaux de la LARHC = 9064 $ Au vs ORHC = 7881 $ Au; p < 0.01). La durée de l’intervention était significativement plus longue (LARHC: 261 minutes vs ORHC: 203 minutes; p < 0.001) et on a utilisé significativement plus d’instruments à usage unique avec une différence de coûts de 854 $ Au vs 189 $ Au, p < 0.001). Cette étude démontre que la colectomie sous laparoscopie pour cancer colique ne présente aucun avantage économique par rapport à la colectomie classique.
Resumen
El propósito del presente estudio fue el de estimar y comparar los costos de la hemicolectomía derecha abierta versus la operación asistida por laparoscopia en pacientes con cáncer. Se hizo un análisis retrospectivo de 61 paciente consecutivos operados entre enero de 1992 y agosto de 1994 por cáncer del colon derecho: hemicolectomía derecha asistida por laparoscopia (HCDAL, n = 28) o hemicolectomía derecha abierta (HCDA, n = 33). El análisis se enfocó hacia e costo (en $AU) causados desde la fecha de la operación hasta la fecha del egreso. La HCDAL resultó significativamente más costosa que la HCDA (costo total de la HCDAL $9064, HCDA $7881; p < 0.001). La HCDAL se asoció con un tiempo más prolongado en la sala de operaciones (HCDAL 261 minutos, HCDA 203 minutos; p < 0.001) y un mayor costo de los elementos desechables (HCDAL $854, HCDA $189; p < 0.001). El estudio demuestra que no hay beneficio en cuanto a costo para la HCDAL en comparación con la HCDA, realizadas por cáncer.
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Philipson, B.M., Bokey, E.L., Moore, J.W.E. et al. Cost of open versus laparoscopically assisted right hemicolectomy for cancer. World J. Surg. 21, 214–217 (1997). https://doi.org/10.1007/s002689900219
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DOI: https://doi.org/10.1007/s002689900219