Systematic review of the costs of laparoscopic colorectal surgery

被引:59
作者
Dowson, Henry M.
Huang, Andy
Soon, Yuen
Gage, Heather
Lovell, David P.
Rockall, Timothy A.
机构
[1] Royal Surrey Cty Hosp, Minimal Access Therapy Training Unit, Surrey, England
[2] Univ Surrey, Dept Econ, Surrey, England
[3] Univ Surrey, Postgrad Med Sch, Dept Med Stat, Surrey, England
关键词
Laparoscopy; laparoscopic surgery; colorectal surgery; costs; health care costs; hospital costs;
D O I
10.1007/s10350-007-0234-5
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: Recent studies have confirmed the clinical efficacy of laparoscopic colorectal surgery; however, its use has not become widespread. One reason for this is perceived economic implications. A systematic review was undertaken examining the costs of laparoscopic colorectal surgery. METHODS: Electronic databases were searched for articles comparing laparoscopic colorectal surgery and open surgery. Primary outcome measures were operating room, direct hospital, and indirect costs. Secondary outcomes were conversion rates and length of hospital stay. The percentage difference in costs was used for comparisons between studies. RESULTS: Twenty-nine articles were identified in which cost data were presented (total number of patients 3,681); the economic data in most studies was limited. Operating room costs were greater for laparoscopic colorectal surgery than open surgery in all studies (median difference, 50 percent; interquartile range, 27-78 percent; P < 0.001). There was no overall difference in total hospital costs (median difference, 0 percent; interquartile range, -17.5 to 21 percent). Only two articles collected data on indirect costs, with both in favor of laparoscopic colorectal surgery. Hospital stay was shorter for laparoscopic colorectal surgery in all studies (median difference, 2.8 days; interquartile range, 1.3-3.7; P < 0.001). Median conversion rate was 7.8 percent (mean, 14 percent; interquartile range, 6-21 percent). CONCLUSIONS: Operating room costs are greater for laparoscopic colorectal surgery than open surgery. Total hospital costs are similar. There may be societal benefits associated with lower indirect costs for laparoscopic colorectal surgery. Cost should not be a deterrent to performing laparoscopic colorectal surgery.
引用
收藏
页码:908 / 919
页数:12
相关论文
共 60 条
[51]   Laparoscopic vs conventional ileocolectomy for primary Crohn disease [J].
Shore, G ;
Gonzalez, QH ;
Bondora, A ;
Vickers, SM .
ARCHIVES OF SURGERY, 2003, 138 (01) :76-79
[52]   Comparison of resource utilization and long-term quality-of-life outcomes between laparoscopic and conventional colorectal surgery [J].
Sokolovic, E ;
Buchmann, P ;
Schlomowitsch, F ;
Szues, TD .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2004, 18 (11) :1663-1667
[53]   Randomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse [J].
Solomon, MJ ;
Young, CJ ;
Eyers, AA ;
Roberts, RA .
BRITISH JOURNAL OF SURGERY, 2002, 89 (01) :35-39
[54]   Prospective randomized study of laparoscopic versus open colonic resection for adenocarcinoma [J].
Stage, JG ;
Schulze, S ;
Moller, P ;
Overgaard, H ;
Andersen, M ;
RebsdorfPedersen, VB ;
Nielsen, HJ .
BRITISH JOURNAL OF SURGERY, 1997, 84 (03) :391-396
[55]   Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy -: Applicability, immediate clinical outcome, inflammatory response, and cost [J].
Targarona, EM ;
Gracia, E ;
Garriga, J ;
Martínez-Bru, C ;
Cortés, M ;
Boluda, R ;
Lerma, L ;
Trías, M .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2002, 16 (02) :234-239
[56]  
TUCKER JG, 1995, SURG ENDOSC-ULTRAS, V9, P297
[57]  
VANYE TM, 1994, SURG LAPAROSC ENDOSC, V4, P25
[58]   Laparoscopic resection of colon cancer - Consensus of the European Association of Endoscopic Surgery (EAES) [J].
Veldkamp, R ;
Gholghesaei, M ;
Bonjer, HJ ;
Meijer, DW ;
Buunen, M ;
Jeekel, J ;
Anderberg, B ;
Cuesta, MA ;
Cuschieri, A ;
Fingerhut, A ;
Fleshman, JW ;
Guillou, PJ ;
Haglind, E ;
Himpens, J ;
Jacobi, CA ;
Jakimowicz, JJ ;
Koeckerling, F ;
Lacy, AM ;
Lezoche, E ;
Monson, JR ;
Morino, M ;
Neugebauer, E ;
Wexner, SD ;
Whelan, RL .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2004, 18 (08) :1163-1185
[59]   Advantages of laparoscopic resection for ileocolic Crohn's disease - Improved outcomes and reduced costs [J].
Young-Fadok, TM ;
Long, KH ;
McConnell, EJ ;
Rey, GG ;
Cabanela, RL .
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 2001, 15 (05) :450-454
[60]   Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma [J].
Zheng, Min-Hua ;
Feng, Bo ;
Lu, Ai-Guo ;
Li, Jian-Wen ;
Wang, Ming-Liang ;
Mao, Zhi-Hai ;
Hu, Yan-Yan ;
Dong, Feng ;
Hu, Wei-Guo ;
Li, Dong-Hua ;
Zang, Lu ;
Peng, Yuan-Fei ;
Yu, Bao-Ming .
WORLD JOURNAL OF GASTROENTEROLOGY, 2005, 11 (03) :323-326