Randomized clinical trial of the costs of open and laparoscopic surgery for colonic cancer

Background: 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. Methods: 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. Results: 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 (sic)1846; P = 0.104). The cost of operation was significantly higher for LCR than for OCR (difference in means (sic)1171; P < 0.001), as was the cost of the first admission (difference in means (sic)1556; P = 0.015) and the total cost to the healthcare system (difference in means (sic)2244; P = 0.018). Conclusion: 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.