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The study compared in-hospital costs of patients randomized to laparoscopic or open colectomy, combined with fast track or standard care.Data from the LAFA-trial database were used. In this trial, fast track care was compared with standard perioperative care in 400 patients undergoing laparoscopic or open colon surgery for colorectal cancer. The marginal direct medical costs were calculated per patient for the four treatment strategies. These included outpatient care, operating time, patient days, additional costs of laparoscopy and of fast track care and costs of complications, reoperations and readmissions within 30 days after the index operation. In-hospital costs were separately analysed for the tertiary and teaching hospitals.There were no statistically significant differences, adjusted for the type of hospital, between in-hospital costs per treatment strategy (P = 0.560 and P = 0.411,). As in-hospital costs were comparable, a cost-effectiveness analysis was not performed.In-hospital costs for patients who underwent laparoscopic or open resection combined with fast track care or standard care are similar.