Laparoscopic Colectomy is Cost-Effective for Managing Sigmoid Diverticular Disease

PHILADELPHIA, PA -- April 2, 2002 -- Laparoscopic colectomy is a cost-effective means of electively managing sigmoid diverticular disease, according to a new study published in the April 2002 issue of Diseases of the Colon & Rectum, the official journal of the American Society of Colon and Rectal Surgeons (ASCRS).

"Laparoscopic colectomy may become very important in an era of increasing constraints on hospital occupancy rates and access to nursing services in many areas of the country," explained lead investigator and colorectal surgeon Anthony J. Senagore, MD, MS, MBA. "Comparison of the components of cost between laparoscopic colectomy and open colectomy demonstrated significantly greater costs for the open colectomy related to laboratory studies, pharmacy costs, and hospitalization. With the laparoscopic colectomy, there was a slight but significant increase in operating room costs."

Conducted by researchers at the Cleveland Clinic Foundation in Cleveland, Ohio, the study analyzed 132 elective sigmoid colectomies (71 open and 61 laparoscopic) performed from March 1, 1999, through December 31, 2000.

The laparoscopic group had a significantly shorter hospital length of stay, fewer pulmonary complications, and fewer wound infections. Total direct cost in U.S. dollars (provided by Stanford's integrated hospital cost management and decision software) per case was significantly less for laparoscopic procedures ($3,458) than for open colectomies ($4,321).

Previous studies analysing the cost of laparoscopic versus open colectomy have shown conflicting results.

"The major limitation of these other studies was the inclusion of patients who underwent surgery early in the surgical team's learning curve and before any standardisation of processes," Dr. Senagore said. "We believe we were able to show cost savings with laparoscopic colectomy compared to open colectomy by using an experienced laparoscopic team, a standardised technique and through the judicious use of disposable equipment. The fact that laparoscopic colectomy patients can eat earlier and be safely discharged earlier with fewer complications adds further value to this procedure."

[American Society of Colon and Rectal Surgeons]