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Comment & Response
December 2015

Financial Benefits of Laparoscopic ColectomyCould They Be Even Greater?

Author Affiliations
  • 1Department of Biosurgery and Surgical Technology, Imperial College London, London, England
  • 2Health Services Research and Management, School of Health Sciences, City University, London, England
  • 3St Mark’s Academic Institute, St Mark’s Hospital, Harrow, England
JAMA Surg. 2015;150(12):1202. doi:10.1001/jamasurg.2015.2776

To the Editor We applaud the efforts of Crawshaw and colleagues1 to evaluate the effects of laparoscopic colectomy on health care utilization and costs. Such an economic comparison is long overdue in the literature, but we feel that the authors may have overly truncated their clinical scope in an attempt to achieve some homogeneity among the 2 groups studied. Once emergency cases and cases of cancer and inflammatory bowel disease have been excluded, cases of diverticular resection are mainly all that is left. By extension, this would also limit the range of procedures to mostly left-sided surgical procedures. We would imagine that, with the inclusion of cancer and inflammatory bowel disease cases in this comprehensive analysis, the observed economic differences would still be seen, and may indeed be greater, but this would be more representative of a colorectal surgeon’s case mix.

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