Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease

Similarities and differences

Anthony J. Senagore, Hans J. Duepree, Conor P. Delaney, Sharmilla Dissanaike, Karen M. Brady, Victor W. Fazio

Research output: Contribution to journalArticle

166 Citations (Scopus)

Abstract

PURPOSE: Although laparoscopic colectomy has demonstrated a variety of advantages, it remains unclear whether the reductions in length of stay and faster return of bowel function will offset potential increases in cost caused by operating time and instrumentation. The purpose of this study was to compare the direct cost structure of elective open and laparoscopic resection for sigmoid diverticulitis. METHODS: We compared consecutive elective open and laparoscopic sigmoid colectomies (n = 71 and n = 61, respectively) performed from March 1, 1999, through December 31, 2000. Data collected included age, gender, body mass index, American Society of Anesthesia score, indication for surgery, morbidity, mortality, conversion (laparoscopic only), operating time, and length of hospital stay. Direct cost data were provided by Stanford's integrated hospital cost management and decision software. Indirect costs and total costs were not addressed. Data were analyzed by Student's t-test and chi-squared test where appropriate. Significance was set at P <0.05. All data are presented as mean ± standard error of the mean. RESULTS: There were 132 elective sigmoid colectomies for diverticular disease (61 laparoscopic and 71 open procedures). There were no significant differences between the groups with respect to age, male/female ratio, or body mass index. Operating time was similar (109 ± 7 minutes for laparoscopic procedures vs. 101 ± 7 minutes for open procedures). The laparoscopic group had a significantly shorter length of stay (3.1 ± 0.2 vs. 6.8 ± 0.4 days), fewer pulmonary complications (1 (1.6 percent) vs. 4 (5.6 percent)) and fewer wound infections (0 vs. 5 (7 percent)). Conversion to open colectomy was required in 4 (6.6 percent) of 61 patients. Readmission occurred in three laparoscopic colectomy patients (4.9 percent) and four open colectomy patients (5.6 percent). There was one operative death in the laparoscopic group (1.6 percent) and no deaths in the open group. Total direct cost per case was significantly less for laparoscopic procedures ($3,458 ± 437) than for open colectomies ($4321 ± 501; P <0.05, Student's t-test), and operating costs were not significantly different between the groups. CONCLUSION: The data demonstrate that laparoscopic colectomy is a cost-effective means of electively managing sigmoid diverticular disease. This operative approach may become very important in an era of increasing constraints on hospital occupancy rates and access to nursing services in many regions of the country.

Original languageEnglish (US)
Pages (from-to)485-490
Number of pages6
JournalDiseases of the Colon and Rectum
Volume45
Issue number4
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Colectomy
Sigmoid Colon
Costs and Cost Analysis
Length of Stay
Sigmoid Diseases
Body Mass Index
Students
Nursing Services
Diverticulitis
Hospital Costs
Wound Infection
Software
Anesthesia
Morbidity
Lung
Mortality

Keywords

  • Cost analysis
  • Diverticular disease
  • Laparoscopic sigmoidectomy

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease : Similarities and differences. / Senagore, Anthony J.; Duepree, Hans J.; Delaney, Conor P.; Dissanaike, Sharmilla; Brady, Karen M.; Fazio, Victor W.

In: Diseases of the Colon and Rectum, Vol. 45, No. 4, 2002, p. 485-490.

Research output: Contribution to journalArticle

Senagore, Anthony J. ; Duepree, Hans J. ; Delaney, Conor P. ; Dissanaike, Sharmilla ; Brady, Karen M. ; Fazio, Victor W. / Cost structure of laparoscopic and open sigmoid colectomy for diverticular disease : Similarities and differences. In: Diseases of the Colon and Rectum. 2002 ; Vol. 45, No. 4. pp. 485-490.
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