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Laparoscopic Resection in Rectal Cancer Patients: Outcome and Cost-Benefit Analysis

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Diseases of the Colon & Rectum

Purpose

This study was designed to evaluate the impact of laparoscopic rectal resection on short-term postoperative morbidity and costs.

Methods

A total of 168 patients with rectal cancer were randomly assigned to laparoscopic (n = 83) or open (n = 85) resection. Outcome parameters were: postoperative morbidity, length of hospital stay, quality of life, long-term survival, and local recurrences. The mean follow-up period was 53.6 months. Cost-benefit analysis was based on hospital costs.

Results

Operative time was 53 minutes longer in the laparoscopic group (P < 0.0001). Postoperative morbidity rate was 28.9 percent in the laparoscopic vs. 40 percent in the open group (P = 0.18). The mean length of hospital stay was 10 (4.9) days in the laparoscopic group and 13.6 (10) days in the open group (P = 0.004). Local recurrence rate and five-year survival were similar in both groups; however, the limited number of patients does not allow firm conclusions. Quality of life was better in the laparoscopic group only in the first year after surgery (P < 0.0001). The additional charge in the laparoscopic group was $1,748 per patient randomized ($1,194 the result of surgical instruments and $554 the result of longer operative time). The saving in the laparoscopic group was $1,396 per patient randomized ($647 the result of shorter length of hospital stay and $749 the result of the lower cost of postoperative complications). The net balance resulted in $351 extra cost per patient randomly allocated to the laparoscopic group.

Conclusions

Short-term postoperative morbidity was similar in the two groups. Laparoscopic resection reduced length of hospital stay, improved first-year quality of life, and slightly increased hospital costs.

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Authors and Affiliations

  1. Department of Surgery, San Raffaele University, Via Olgettina, 60, Milan, 20132, Italy

    Marco Braga M.D., Matteo Frasson M.D., Andrea Vignali M.D., Walter Zuliani M.D., Giovanni Capretti M.D. & Valerio Di Carlo M.D.

Authors
  1. Marco Braga M.D.
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  2. Matteo Frasson M.D.
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  3. Andrea Vignali M.D.
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  4. Walter Zuliani M.D.
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  5. Giovanni Capretti M.D.
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  6. Valerio Di Carlo M.D.
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Corresponding author

Correspondence to Marco Braga M.D..

Additional information

Read at the meeting of The American Society of Colon and Rectal Surgeons, Seattle, Washington, June 3 to 7, 2006.

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Braga, M., Frasson, M., Vignali, A. et al. Laparoscopic Resection in Rectal Cancer Patients: Outcome and Cost-Benefit Analysis. Dis Colon Rectum 50, 464–471 (2007). https://doi.org/10.1007/s10350-006-0798-5

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  • DOI: https://doi.org/10.1007/s10350-006-0798-5

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