Clinical and Economic Outcomes

Rates of surgical site infection are consistently lower (often significantly) with laparoscopic colorectal surgery than with open colorectal surgery.^1,4,5

Length of hospital stay is significantly shorter following laparoscopic colorectal surgery than with open colorectal surgery.^1,2,6,8,12,([FOOTNOTE=Bartels SA, Vlug MS, Ubbink DT, Bemelman WA. Quality of life after laparoscopic and open colorectal surgery: a systematic review. World J Gastroenterol. 2010 Oct 28;16(40):5035-41.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Aly OE, Quayyum Z. Has laparoscopic colorectal surgery become more cost-effective over time? Int J Colorectal Dis. 2012 Jul;27(7):855-60.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Wang CL, Qu G, Xu HW. The short- and long-term outcomes of laparoscopic versus open surgery for colorectal cancer: a meta-analysis. Int J Colorectal Dis. 2014 Mar;29(3):309-20.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Ma Y, Yang Z, Qin H, Wang Y. A meta-analysis of laparoscopy compared with open colorectal resection for colorectal cancer. Med Oncol. 2011 Dec;28(4):925-33.],[ANCHOR=],[LINK=])

Blood loss during surgery is significantly lower with laparoscopic versus open colorectal surgery.^6,([FOOTNOTE=Ohtani H, Tamamori Y, Arimoto Y, et al. A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy-assisted and conventional open surgery for colorectal cancer. J Cancer. 2011;(2):425-34.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Kuhry E, Schwenk WF, Gaupset R, Romild U, Bonjer HJ. Long-term results of laparoscopic colorectal cancer resection. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003432.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Di B, Li Y, Wei K, et al. Laparoscopic versus open surgery for colon cancer: a meta-analysis of 5-year follow-up outcomes. Surg Oncol. 2013 Sep;22(3):e39-43.],[ANCHOR=],[LINK=])

Studies show that the operating time associated with laparoscopic colorectal surgery is consistently and significantly longer than with open surgery.^{2,4,7,9,12,21-23} 

In US-based studies, total hospital costs for laparoscopic colorectal resection were generally lower than for open colorectal resection.([FOOTNOTE=Kang CY, Chaudhry OO, Halabi WJ, et al. Outcomes of laparoscopic colorectal surgery: data from the Nationwide Inpatient Sample 2009. Am J Surg. 2012 Dec;204(6):952-7.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Steele SR, Brown TA, Rush RM, Martin MJ. Laparoscopic vs open colectomy for colon cancer: results from a large nationwide population-based analysis. J Gastrointest Surg. 2008 Mar;12(3):583-91.],[ANCHOR=],[LINK=])^,([FOOTNOTE=da Luz Moreira A, Kiran RP, Kirat HT, et al. Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs. Surg Endosc. 2010 Jun;24(6):1280-6.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Marshall CL, Chen GJ, Robinson CN, et al. Establishment of a minimally invasive surgery program leads to decreased inpatient cost of care in veterans with colon cancer. Am J Surg. 2010 Nov;200(5):632-5.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Eisenberg DP, Wey J, Bao PQ, et al. Short- and long-term costs of laparoscopic colectomy are significantly less than open colectomy. Surg Endosc. 2010 Sep;24(9):2128-34.],[ANCHOR=],[LINK=])^,([FOOTNOTE=Vaid S, Tucker J, Bell T, Grim R, Ahuja V. Cost analysis of laparoscopic versus open colectomy in patients with colon cancer: results from a large nationwide population database. Am Surg. 2012 Jun;78(6):635-41.],[ANCHOR=],[LINK=]) 

In the UK, there was no significant difference in total hospital costs for open versus laparoscopic colorectal resection.([FOOTNOTE=Ding J, Xia Y, Liao GQ, et al. Hand-assisted laparoscopic surgery versus open surgery for colorectal disease: a systematic review and meta-analysis. Am J Surg. 2014 Jan;207(1):109-19.],[ANCHOR=],[LINK=])