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Purpose: Our aim was to compare the costs associated with hand-assisted laparoscopic colectomy (HALC) and open colectomy (OC)., Methods: The data of patients who underwent either HALC or OC between March 2009 and August 2010 were retrospectively reviewed. The assessed short-term outcomes included operative time, blood lost, retrieved lymph nodes, conversion rates, and complications. Direct costs of operating room, nursing, intensive care, anesthesia, laboratory, pharmacy, radiology, and other costs related to initial hospitalization were compared., Results: Forty-two patients underwent HALC, whereas 45 underwent OC. Demographics in both groups were similar. The HALC patients had significantly shorter hospital stays and incision lengths, faster recovery of bowel function, and less blood loss (P<.001). There were no significant differences in operative time (169 minutes for HALC versus 171 minutes for OC), complication rates, or the number of retrieved lymph nodes. Although operative costs were higher for HALC (US $2260 versus $1992; P<.001), total costs were not significantly different between both methods (US $5593 vs. $5638; P=.29)., Conclusion: Total costs of HALC are not significantly higher compared with OC. HALC is safe and leads to better short-term outcomes than OC.