Cost analysis of single-incision versus conventional laparoscopic surgery for colon cancer: A propensity score-matching analysis

Background/objective: Although many studies have demonstrated similar perioperative outcomes for single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) for colon cancer, few have directly compared the costs of them. We aimed to compare costs between SILS and CLS for colon cancer. Methods: We analyzed the clinical outcomes and overall hospital costs of patients who underwent laparoscopic surgery for colon cancer from July 2009 to September 2014 at our institution; 288 were used for analysis after propensity score matching. The total hospital charge, including fees for the operation, anesthesia, preoperative diagnosis, and postoperative management was analyzed. Results: The total hospital charges were similar in both groups ($8770.40 vs. $8352.80, P = 0.099). However, the patients' total hospital bill was higher in the SILS group than in the CLS group ($4184.82 vs. $3735.00, P < 0.001) mainly due to the difference of the cost of access devices. There was no difference in the additional costs associated with readmission due to late complications between the two groups ($2383.08 vs. $2288.33, P = 0.662). Incremental cost-effectiveness ratio for total incision length in ‘total hospital charge’ and patient's bill and government's bill in ‘cost of instruments and supplies’ were -$107.08/1 cm, -$109.70/1 cm, and $80.64/1 cm, respectively. Conclusion: SILS for colon cancer yielded similar costs as well as perioperative and long-term outcomes compared with CLS. Therefore, SILS can be considered a reasonable treatment option for colon cancer for selective patients.