Quereshy, Fayez

BackgroundSimultaneous resection for colorectal cancer with synchronous liver metastases is an established alternative to a staged approach. This study aimed to compare these approaches with regards to economic parameters and short‐term outcomes.MethodsA retrospective cohort analysis was conducted between 2005 and 2016. The primary outcome was cost per episode of care. Secondary measures included 30‐day clinical outcomes. A multivariate analysis was performed to determine the adjusted effect of a simultaneous surgical approach on total cost of care.ResultsFifty‐three cases were identified; 27 in the staged approach, and 26 in the simultaneous group. Age (P = 0.49), sex (P = 0.20), BMI (P = 0.74), and ASA class (P = 0.44) were comparable between groups. Total cost ($20297 vs $27522), OR ($6830 vs $10376), PACU ($675 vs $1182), ward ($7586 vs $11603) and pharmacy costs ($728 vs $1075) were significantly less for the simultaneous group (P < 0.05). The adjusted rate ratio for total cost of care in the staged group compared to simultaneous group was 1.51 (95%CI: 1.16‐1.97, P < 0.05). The groups had comparable Clavien‐Dindo scores (P = 0.89), 30‐day readmissions (P = 0.44), morbidity (P = 0.50) and mortality (P = 1.00).ConclusionsOur study demonstrates that a simultaneous approach is associated with a significantly lower total cost while maintaining comparable short‐term outcomes.