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Systematic Review of the Costs of Laparoscopic Colorectal Surgery

  • Current Status
  • W. Donald Buie, M.D., Editor
  • Published:
Diseases of the Colon & Rectum

Purpose

Recent studies have confirmed the clinical efficacy of laparoscopic colorectal surgery; however, its use has not become widespread. One reason for this is perceived economic implications. A systematic review was undertaken examining the costs of laparoscopic colorectal surgery.

Methods

Electronic databases were searched for articles comparing laparoscopic colorectal surgery and open surgery. Primary outcome measures were operating room, direct hospital, and indirect costs. Secondary outcomes were conversion rates and length of hospital stay. The percentage difference in costs was used for comparisons between studies.

Results

Twenty-nine articles were identified in which cost data were presented (total number of patients 3,681); the economic data in most studies was limited. Operating room costs were greater for laparoscopic colorectal surgery than open surgery in all studies (median difference, 50 percent; interquartile range, 27–78 percent; P < 0.001). There was no overall difference in total hospital costs (median difference, 0 percent; interquartile range, −17.5 to 21 percent). Only two articles collected data on indirect costs, with both in favor of laparoscopic colorectal surgery. Hospital stay was shorter for laparoscopic colorectal surgery in all studies (median difference, 2.8 days; interquartile range, 1.3–3.7; P < 0.001). Median conversion rate was 7.8 percent (mean, 14 percent; interquartile range, 6–21 percent).

Conclusions

Operating room costs are greater for laparoscopic colorectal surgery than open surgery. Total hospital costs are similar. There may be societal benefits associated with lower indirect costs for laparoscopic colorectal surgery. Cost should not be a deterrent to performing laparoscopic colorectal surgery.

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Authors and Affiliations

  1. Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Guildford, Surrey, United Kingdom

    Henry M. Dowson M.R.C.S., Andy Huang F.R.C.S., Yuen Soon F.R.C.S. & Timothy A. Rockall F.R.C.S.

  2. Department of Economics, University of Surrey, Guildford, Surrey, United Kingdom

    Heather Gage Ph.D.

  3. Department of Medical Statistics, Postgraduate Medical School, University of Surrey, Guildford, Surrey, United Kingdom

    David P. Lovell Ph.D.

  4. Laparoscopic Research Fellow, MATTU, Guildford, Surrey, GU2 4JX, United Kingdom

    Henry M. Dowson M.R.C.S.

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  1. Henry M. Dowson M.R.C.S.
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  2. Andy Huang F.R.C.S.
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  3. Yuen Soon F.R.C.S.
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Correspondence to Henry M. Dowson M.R.C.S..

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Dowson, H.M., Huang, A., Soon, Y. et al. Systematic Review of the Costs of Laparoscopic Colorectal Surgery. Dis Colon Rectum 50, 908–919 (2007). https://doi.org/10.1007/s10350-007-0234-5

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