An Sanghyun, Hong Sung Eun, Kim Moo Hyun, Kim Ik Yong
Department of Colorectal Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Review and Assessment Division, Seoul Branch Office, Health Insurance Review and Assessment Service, Seoul, Republic of Korea.
Front Surg. 2025 Jan 20;12:1543920. doi: 10.3389/fsurg.2025.1543920. eCollection 2025.
We aimed to compare and analyze the cost-effectiveness of laparoscopic vs. open colorectal surgery (CRS) for colorectal cancer using health insurance claims data derived from multiple institutions in South Korea as well as the differences in hospital length of stay (LOS) and 30-day readmission rates related to postoperative complications.
We retrospectively reviewed the clinical data of patients who underwent curative resection for colorectal cancer between January 1, 2020 and December 31, 2022 using national health insurance claims data in South Korea. We determined the surgical approach based on the presence or absence of treatment material codes specific to laparoscopic surgery, and divided the patients into the laparoscopic-CRS (lap-CRS) and open-CRS groups.
A total of 34,779 patients were included [open-CRS: 3,262 patients [9.4%]; lap-CRS: 31,517 patients [90.6%]]. The mean LOS was 14.11 and 11.27 days for the open- and lap-CRS groups, respectively ( < 0.001). The mean medical costs were 9,163 USD and 8,963 USD in the open- and lap-CRS groups, respectively ( < 0.001). A total of 1,192 (3.4%) patients were readmitted within 30 days of discharge, with a rate of 5.4% (176 cases) and 3.2% (1,016 cases) in the open- and lap-CRS groups, respectively ( < 0.001). Open surgery, male sex, and rectal surgery were identified as factors that increased medical cost.
According to this South Korean nationwide population-based study, laparoscopic surgery demonstrated a reduction in LOS, medical costs, and readmission rates compared with open surgery in patients with colorectal cancer.
我们旨在利用来自韩国多个机构的医疗保险理赔数据，比较和分析腹腔镜与开放结直肠癌手术（CRS）治疗结直肠癌的成本效益，以及住院时间（LOS）差异和与术后并发症相关的30天再入院率。
我们回顾性分析了2020年1月1日至2022年12月31日期间在韩国接受结直肠癌根治性切除患者的临床数据，这些数据来自国家医疗保险理赔数据。我们根据是否存在腹腔镜手术特有的治疗材料代码来确定手术方式，并将患者分为腹腔镜CRS（lap-CRS）组和开放CRS组。
共纳入34779例患者[开放CRS：3262例患者（9.4%）；lap-CRS：31517例患者（90.6%）]。开放CRS组和lap-CRS组的平均住院时间分别为14.11天和11.27天（<0.001）。开放CRS组和lap-CRS组的平均医疗费用分别为9163美元和8963美元（<0.001）。共有1192例（3.4%）患者在出院后30天内再次入院，开放CRS组和lap-CRS组的再入院率分别为5.4%（176例）和3.2%（1016例）（<0.001）。开放手术、男性性别和直肠手术被确定为增加医疗费用的因素。
根据这项基于韩国全国人群的研究，与开放手术相比，腹腔镜手术在结直肠癌患者中显示出住院时间、医疗费用和再入院率的降低。
