• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Getting More for Your Money: Laparoscopic Rectal Surgery Provides Similar Short Term Outcomes and Shorter Length of Stay at Comparable Costs to Open Surgery

Krista Hardy, MSc MD, Josephine Kwong, BScH MPA, Kristen Pitzul, BScH MSc, Ashley Vergis, MD MMed, Timothy Jackson, MD MPH, David Urbach, MD MSc, Allan Okrainec, MD MHPE. University of Manitoba, Winnipeg, Man., Department of General Surgery, University Health Network, University of Toronto, Toronto, Ont., Canada

 

Introduction: The benefits of laparoscopic surgery in the management of colon cancer have been well established. Controversy remains in the application of this technique in rectal cancer. The objective of this study was to compare the early outcomes and total hospital cost of laparoscopic (lap) and open rectal surgery.Methods and Procedures: Patients undergoing elective lap or open rectal resection at the University Health Network, University of Toronto from April 2004 – March 2009 were included. Patient demographic, operative (OR) and outcome data was obtained from electronic hospital records. Cost data was determined from the hospital case costing system and median costs were compared using the Mann-Whitney U Test. Conversions to open surgery were analyzed on an intention-to-treat basis. Binary logistic regression analysis was used to compare differences in baseline patient characteristics. Pathology reports were reviewed for tumor status, nodal harvest and resection margins. The relationship between length of stay and cost was determined with analysis of covariance.

Results: There were 68 (26%) lap and 191 (74%) open rectal resections. The rate of conversion to open surgery was 28.8%. There was no difference in preoperative body mass index, gender, American Society of Anesthesiology score or Charlson Index. Open patients were more likely to have a previous laparotomy (40.8 vs 17.6 %, open vs lap, p= 0.001). Most patients had a final pathologic diagnosis of invasive cancer (85.1 vs 81.7, lap vs open, p=0.525). Median operative time was slightly longer for lap surgery (291 vs 254 min, lap vs open, p=0.005), while median length of stay was less for lap surgery (6 vs 8 days, lap vs open, p=0.000). Rates of neoadjuvant therapy were similar for invasive cancers. There was no difference in T status, N status, number of nodes resected or margin status (Table). Complication rates were similar (21.2% vs 22.0%, lap vs open, p=1.000). There were no differences in ICU admissions, reoperations, 30-day readmissions or emergency room visits. Lap surgery was associated with higher operative cost ($4 656.56 vs $4 292.79, lap vs open, p=0.014) but lower ward cost ($4 050.96 vs $5 222.61, lap vs open, p=0.003). Total hospital cost was similar for lap and open surgery ($11 661.79 vs $12 449.34, lap vs open, p=0.097) Length of stay was a significant predictor of cost (p=0.001).

Conclusion: The laparoscopic approach was associated with similar short term outcomes and shorter length of stay. Examination of costs revealed a similar total hospital cost for both procedures with higher operative and lower ward costs associated with laparoscopic approach. This study is consistent with previous literature supporting the short term benefits of laparoscopy and furthermore demonstrates comparable costs between procedures. 


Session Number: Poster – Poster Presentations
Program Number: P104
View Poster

124

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons