Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial)

The short-term clinical results of the CLASICC trial indicated that clinical outcomes were similar between laparoscopic and open approaches. This study presents the short-term (3 month) cost analysis undertaken on a subset of patients entered into the CLASICC trial (682 of 794 patients). As expected the costs associated with the operation were higher in the 452 patients randomised to laparoscopic surgery (lap) compared with the 230 randomised to open procedure (open), 1703 pound vs 1386 pound. This was partially offset by the other hospital (nontheatre) costs, which were lower in the lap group (2930 pound vs 3176) pound. The average cost to individuals for reoperations was higher in the lap group (762 pound vs 553) pound. Overall costs were slightly higher in the lap group (6899 pound vs 6631) pound, with mean difference of 268 pound (95% CI - 689 to 1457). Sensitivity analysis made little difference to these results. The cost of rectal surgery was higher than for colon, for lap (8259 pound vs 5586) pound and open procedures (7820 pound vs 5503) pound. The short-term cost analysis for the CLASICC trial indicates that the costs of either laparoscopic or open procedure were similar, lap surgery costing marginally more on average than open surgery.