Division of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15261, USA.
Surg Endosc. 2010 Sep;24(9):2128-34. doi: 10.1007/s00464-010-0909-1. Epub 2010 Feb 21.
The financial impact of laparoscopic colectomy remains poorly defined. We report the short-term costs of laparoscopic colectomy (LC) as compared with open colectomy (OC) in a high-volume tertiary care hospital, and are the first to incorporate the costs of late, colectomy-related complications in an analysis of long-term costs.
A retrospective analysis of patients undergoing elective laparoscopic (n = 76) or open (n = 162) colon resection between January 2004 and December 2006 was performed. Primary endpoints were total hospital cost of the index admission and total hospital cost for any subsequent admission for treatment of a colectomy-related complication.
Two-hundred thirty-eight patients met inclusion criteria. Mean total hospital cost was significantly greater for patients undergoing OC (US $17,686 per patient versus US $14,518, P = 0.0003). Mean total operative costs were equivalent (US $7,451 OC versus US $7,794 LC, P = 0.274). Average length of stay was shorter for LC (5.2 versus 6.9 days, P < 0.0001). Late complication rates were 5.6% (OC) and 2.6% (LC). Integrating the cost of late complications further increased the disparity between the total cost of OC (US $18,296 per patient, 3.4% increase) as compared with LC (US $14,789, 1.9% increase).
We demonstrate both short- and long-term financial benefits of LC in a high-volume tertiary care hospital.
腹腔镜结肠切除术的经济影响仍未明确界定。我们报告了在一家高容量的三级护理医院中，腹腔镜结肠切除术（LC）与开腹结肠切除术（OC）相比的短期成本，并且首次在长期成本分析中纳入了迟发性、与结肠切除术相关的并发症的成本。
对 2004 年 1 月至 2006 年 12 月期间接受择期腹腔镜（n = 76）或开腹（n = 162）结肠切除术的患者进行了回顾性分析。主要终点是索引入院的总住院费用和任何后续因治疗与结肠切除术相关的并发症而入院的总住院费用。
238 名患者符合纳入标准。OC 组患者的总住院费用明显更高（每位患者 17686 美元，而 LC 组为 14518 美元，P = 0.0003）。平均总手术费用相当（OC 组为 7451 美元，LC 组为 7794 美元，P = 0.274）。LC 组的平均住院时间更短（5.2 天对 6.9 天，P < 0.0001）。迟发性并发症发生率为 5.6%（OC）和 2.6%（LC）。将迟发性并发症的成本纳入后，OC 的总费用（每位患者 18296 美元，增加 3.4%）与 LC（每位患者 14789 美元，增加 1.9%）之间的差距进一步加大。
我们在一家高容量的三级护理医院中证明了 LC 在短期和长期都具有经济优势。
