期刊
ANNALS OF SURGICAL ONCOLOGY
卷 29, 期 3, 页码 1923-1934出版社
SPRINGER
DOI: 10.1245/s10434-021-10902-5
关键词
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资金
- Colorectal Surgical Society of Australia and New Zealand (CSSANZ) Foundation
- National Health and Medical Research Council (NHMRC) [1009973, 1078113]
- Cancer Council Queensland
- Robinson Fellowship at the University of Sydney
- Australian NHMRC TRIP Fellowship
- National Health and Medical Research Council of Australia [1078113] Funding Source: NHMRC
The study compared total healthcare costs of laparoscopic-assisted surgery and open resection for rectal cancer over a 12-month period. Despite initial differences in costs, the average costs were found to be similar at 12 months, allowing clinicians to choose the surgical approach based on clinical need.
Background. Laparoscopic-assisted surgery for rectal cancer is widely used, however the healthcare costs are thought to be higher than for open resection. This secondary endpoint analysis of a randomized controlled trial aimed to evaluate total healthcare costs of laparoscopic-assisted surgery compared with open resection for rectal cancer over a 12-month period. Methods. Patients in the Australasian Laparoscopic Cancer of the Rectum Trial (ALaCaRT) were included in a prospective costing analysis. All healthcare use for the index surgery and hospital admission, readmissions, and follow-up care over 12 months were included. Unit costs were valued in Australian dollars (AUD$) using scheduled Medicare fees and hospital cost weights. The primary outcome was mean per patient cost. Non-parametric bootstrapping with 10,000 replications was undertaken for robustness checks. Results. Data from 468 patients indicated that the laparoscopic-assisted surgical procedure incurred a mean cost of AUD$4542 (standard deviation [SD] AUD$1050)-AUD$521 higher than the open procedure mean cost of AUD$4021 (SD AUD$804) due to longer operative time and involvement of more costly equipment (95% confidence interval [CI] AUD$354-AUD$692). At 12 months, the average cost for the laparoscopic-assisted and open groups was AUD$43,288 (SD AUD$40,883) and AUD$45,384 (SD AUD$38,659), respectively, due to the shorter subsequent hospital stays. No overall significant cost difference between groups was found (95% CI-AUD$9358 to AUD$5003). One-way sensitivity analyses confirmed the robustness of the results. Conclusion. While initially higher, the costs of laparoscopic-assisted surgery for rectal cancer were similar to open resection at 12 months. Clinicians may choose a surgical approach based on clinical need.
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