Colonoscopic‐assisted laparoscopic wedge resection versus segmental colon resection for benign colonic polyps: a comparative cost analysis

Abstract

AimThe colonoscopic‐assisted laparoscopic wedge resection (CAL‐WR) is proven to be an effective and safe alternative to a segmental colon resection (SCR) for large or complex benign colonic polyps that are not eligible for endoscopic removal. This analysis aimed to evaluate the costs of CAL‐WR and compare them to the costs of an SCR.MethodA single‐centre 90‐day ‘in‐hospital’ comparative cost analysis was performed on patients undergoing CAL‐WR or SCR for complex benign polyps between 2016 and 2020. The CAL‐WR group consisted of 44 patients who participated in a prospective multicentre study (LIMERIC study). Inclusion criteria were (1) endoscopically unresectable benign polyps; (2) residual or recurrence after previous polypectomy; or (3) irradically resected low risk pT1 colon carcinoma. The comparison group, which was retrospectively identified, included 32 patients who underwent an elective SCR in the same period.ResultsColonoscopic‐assisted laparoscopic wedge resection was associated with significantly fewer complications (7% in the CAL‐WR group vs. 45% in the SCR group, P < 0.001), shorter operation time (50 min in the CAL‐WR group vs. 119 min in the SCR group, P < 0.001), shorter length of hospital stay (median length of stay 2 days in the CAL‐WR group vs. 4 days in the SCR group, P < 0.001) and less use of surgical resources (reduction in costs of 32% per patient), resulting in a cost savings of €2372 (£2099 GBP) per patient (P < 0.001).ConclusionGiven the clinical and financial benefits, CAL‐WR should be recommended for complex benign polyps that are not eligible for endoscopic resection before major surgery is considered.