Published online May 15, 2017. doi: 10.4251/wjgo.v9.i5.228
Peer-review started: October 8, 2016
First decision: January 7, 2017
Revised: January 16, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: May 15, 2017
Processing time: 222 Days and 15.5 Hours
To evaluate the costs of the introduction of a laparoscopic surgery program for gastric cancer in a Western community training hospital and tertiary referral centre for gastric cancer surgery.
All patients who underwent surgery for gastric cancer with curative intent in 2013 and 2014 were prospectively included. Primary outcomes were costs regarding surgery and hospital stay.
Laparoscopic gastrectomy was used in 52 patients [mean age 68 years (± 9, range 50 to 87)] and open gastrectomy was used in 25 patients [mean age 70 years (± 10, range 46 to 85)]. Mean costs (in euro’s) of surgical instrumentation were significantly higher for laparoscopic surgery: 2270 ± 670 vs 1181 ± 680 in the open approach (P < 0.001). Costs of theatre use were higher in the laparoscopic group: mean 3819 ± 865 vs 2545 ± 1268 in the open surgery (P < 0.001). Total costs of hospitalization (i.e., costs of surgery and admission) were not different between laparoscopic and open surgery, 8187 ± 4864 and 7673 ± 8064 respectively (P = 0.729). Mean length of hospital stay was 9 ± 12 d in the laparoscopic group vs 14 ± 14 d in the open group (P = 0.044).
The introduction of laparoscopic gastrectomy for gastric cancer coincided with higher costs for theatre use and surgical instrumentation compared to the open technique. Total costs were not significantly different due to shorter length of stay and less intensive care unit (ICU) admissions and shorter ICU stay in the laparoscopic group.
Core tip: The introduction of laparoscopic surgery for gastric cancer did not seem to result in increased costs as compared to open gastrectomy for gastric cancer. Despite higher operating room costs (longer operating time and more costly operating room materials) costs were similar between the open and laparoscopic group due to reduced length of stay and complication rate in laparoscopic gastrectomy patients.