The Effect of Postoperative Complications on 90-Day Hospital Costs in Elective Colon Cancer Surgery

Colon cancer surgery is increasing in the Western world due to the aging population. Although most patients recover uneventfully, postoperative complications cause significant morbidity and increase hospital costs. In this retrospective study we evaluated the impact of postoperative complications on hospital costs. All patients who underwent elective segmental colon resection for colon cancer at Oulu University Hospital between 2014 and 2024 were analyzed for operative details and postoperative complications. Hospital costs—operative costs, hospital stay, possible intensive care, readmissions, and postoperative outpatient clinic visits within 90 days after the primary operation—were obtained from hospital administration and adjusted for inflation. Between 2014 and 2024, 745 patients underwent segmental colon resection. The mean total hospital cost was €13,716 (range: €5,716–155,516). The mean costs were €10,194 for patients recovering without complications (n= 439, 59%), €13,117 for patients with minor complications (n=187, 25%), €22,864 for patients with major complications (n= 75, 10%), and €37,072 for patients with life-threatening complications (n=44, 6%). Anastomotic leakage resulted in an over four-fold increase in costs (mean €45,310). Postoperative complications accounted for 26% of cumulative hospital costs of elective colon cancer surgery. Elective colon cancer surgery is associated with a considerable risk of postoperative complications, which substantially increase overall costs. Complications led to more than a 25-fold variation in individual patient costs. From an institutional perspective, additional costs attributable to postoperative complications represented 26% of cumulative hospital expenditures. Therefore, the economic burden of postoperative complications should be considered when managing colorectal surgery units.