Laparoscopic Colon Resections Speed Hospital Discharges

Patients administered minimally invasive surgery (MIS) colon resection procedures instead of open surgery leave the hospital quicker and require less follow up with physicians and fewer medical prescriptions.

Study results published in JAMA indicated that minimally invasive approaches could provide both near- and long-term financial savings for the healthcare system and simultaneously improved patient outcomes.

Researchers conducted a regression analysis comprised of 4,160 patients with national health insurance claims utilizing data from the Truven Health Analytics MarketScan Commercial Claims and Encounters database. The team measured 3 key outcomes: health care utilization, including office, hospital outpatient, and emergency department visits and inpatient services 90 days and one year after the procedure; health care expenditures; and estimated patient days off from work.

Of the study population, 45.6% underwent elective laparoscopic procedures and 54.4% were administered open colectomy from January 2010 through December 2010.

Results showed that open procedure patients were required to stay in the hospital for 7.4 days, while MIS patients were discharged earlier after 4.5 days. Additionally, the total procedural and hospitalization cost of care for MIS was found to be $24,196 compared to $31,601 for open approaches, a reduction of 23%.

Conor P. Delaney, MD, PhD, University Hospitals Case Medical Center, Cleveland, OH, stated, "We found that the use of minimally-invasive laparoscopic approaches in a select group of patients undergoing colectomy procedures resulted in significantly lower health care costs and resource utilization compared with open surgical approaches. This may expand access and lower the cost of patient care in the long term. These results reflect the well-documented benefits of laparoscopic surgery, which include faster recovery, less pain, and fewer complications."

In the year following surgery, results cited:

§ Overall healthcare expenditures were 18% higher for open surgery compared to MIS

§ Open surgery patients were 112% more likely to be admitted into the hospital as an inpatient compared to MIS

§ Drug expenditures were 13% higher for open surgery compared to MIS

"The widespread adoption of minimally invasive surgery has the potential to improve care, help patients and reduce health care costs. The global medical community must come together to more quickly modernize surgery by increasing the rate of MIS adoption," concluded Michael Tarnoff, MD, vice president and chief medical officer, Covidien Group at Medtronic. "Ultimately, healthcare should be focused on getting patients better, faster and with less pain and MIS achieves that."