Janson M, Björholt I, Carlsson P, Haglind E, Henriksson M, Lindholm E, Anderberg B
Department of Surgery, Centre for Surgical Sciences, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden.
Br J Surg. 2004 Apr;91(4):409-17. doi: 10.1002/bjs.4469.
There has been no randomized clinical trial of the costs of laparoscopic colonic resection (LCR) compared with those of open colonic resection (OCR) in the treatment of colonic cancer.
A subset of Swedish patients included in the Colon Cancer Open Or Laparoscopic Resection (COLOR) trial was included in a prospective cost analysis; costs were calculated up to 12 weeks after surgery. All relevant costs to society were included. No effects of the procedures, such as quality of life or survival, were taken into account.
Two hundred and ten patients were included in the primary analysis, 98 of whom had LCR and 112 OCR. Total costs to society did not differ significantly between groups (difference in means for LCR versus OCR euro1846; P = 0.104). The cost of operation was significantly higher for LCR than for OCR (difference in means euro1171; P < 0.001), as was the cost of the first admission (difference in means euro1556; P = 0.015) and the total cost to the healthcare system (difference in means euro2244; P = 0.018).
Within 12 weeks of surgery for colonic cancer, there was no difference in total costs to society incurred by LCR and OCR. The LCR procedure, however, was more costly to the healthcare system.
在结肠癌治疗中，尚未有关于腹腔镜结肠切除术（LCR）与开放结肠切除术（OCR）成本的随机临床试验。
纳入结肠癌开放或腹腔镜切除术（COLOR）试验中的一部分瑞典患者进行前瞻性成本分析；计算术后12周内的成本。纳入了所有对社会的相关成本。未考虑手术的效果，如生活质量或生存率。
210例患者纳入主要分析，其中98例行LCR，112例行OCR。两组间社会总成本无显著差异（LCR与OCR的均值差为1846欧元；P = 0.104）。LCR的手术成本显著高于OCR（均值差为1171欧元；P < 0.001），首次住院成本（均值差为1556欧元；P = 0.015）以及医疗系统的总成本（均值差为2244欧元；P = 0.018）也是如此。
在结肠癌手术后12周内，LCR和OCR产生的社会总成本无差异。然而，LCR手术对医疗系统而言成本更高。
