Cost-Effective and Potential Benefits in Three-Port Hand-Assisted Laparoscopic Sigmoidectomy

To demonstrate potential benefits of three-port hand-assisted laparoscopic sigmoidectomy (HALS) compared with open sigmoidectomy (OS) in terms of short-term outcomes and cost-benefit.

A retrospective review of a database of cases that matched 100 sigmoid cancer patients treated with sigmoidectomy at the Department of Surgery, Siriraj Hospital was performed. Short-term outcomes and costs of treatment were collected and analyzed.

There were no differences in age, gender body mass index, American Society of Anesthesiologists' score, Charlson comorbidity index score, and previous surgery between OS and HALS groups. The three-port HALS group had significantly less blood loss (50 (5-400) mL vs. 120 (10-1,000) mL, p<0.001), faster time to regular diet (64.6±20.7 hours vs. 97.6±52.5 hours, p<0.001), and lower pain score (4.3±1.7 vs. 5.3±1.6, p = 0.008). The hospital-stay related cost was sign icantly lower in HALS group ($114 ($47-$789) vs. $190 ($57-$1,462), p

Simplified three-port HALS can be successfully performed with superior short-term outcomes and preserved oncologic outcomes. Cost-benefit advantage was highlighted especially in the area of high rate of SST.