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Colonoscopic-assisted laparoscopic wedge resection versus segmental colon resection for benign colonic polyps: a comparative cost analysis.
Hanevelt, Julia; Leicher, Laura W; Moons, Leon M G; Vleggaar, Frank P; Huisman, Jelle F; van Westreenen, Henderik L; de Vos Tot Nederveen Cappel, Wouter H.
Afiliación
  • Hanevelt J; Department of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.
  • Leicher LW; Department of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.
  • Moons LMG; Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
  • Vleggaar FP; Department of Gastroenterology and Hepatology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
  • Huisman JF; Department of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.
  • van Westreenen HL; Department of Surgery, Isala, Zwolle, The Netherlands.
  • de Vos Tot Nederveen Cappel WH; Department of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.
Colorectal Dis ; 25(11): 2147-2154, 2023 11.
Article en En | MEDLINE | ID: mdl-37814456
AIM: The colonoscopic-assisted laparoscopic wedge resection (CAL-WR) is proven to be an effective and safe alternative to a segmental colon resection (SCR) for large or complex benign colonic polyps that are not eligible for endoscopic removal. This analysis aimed to evaluate the costs of CAL-WR and compare them to the costs of an SCR. METHOD: A single-centre 90-day 'in-hospital' comparative cost analysis was performed on patients undergoing CAL-WR or SCR for complex benign polyps between 2016 and 2020. The CAL-WR group consisted of 44 patients who participated in a prospective multicentre study (LIMERIC study). Inclusion criteria were (1) endoscopically unresectable benign polyps; (2) residual or recurrence after previous polypectomy; or (3) irradically resected low risk pT1 colon carcinoma. The comparison group, which was retrospectively identified, included 32 patients who underwent an elective SCR in the same period. RESULTS: Colonoscopic-assisted laparoscopic wedge resection was associated with significantly fewer complications (7% in the CAL-WR group vs. 45% in the SCR group, P < 0.001), shorter operation time (50 min in the CAL-WR group vs. 119 min in the SCR group, P < 0.001), shorter length of hospital stay (median length of stay 2 days in the CAL-WR group vs. 4 days in the SCR group, P < 0.001) and less use of surgical resources (reduction in costs of 32% per patient), resulting in a cost savings of €2372 (£2099 GBP) per patient (P < 0.001). CONCLUSION: Given the clinical and financial benefits, CAL-WR should be recommended for complex benign polyps that are not eligible for endoscopic resection before major surgery is considered.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pólipos del Colon / Laparoscopía Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pólipos del Colon / Laparoscopía Tipo de estudio: Health_economic_evaluation / Prognostic_studies Límite: Humans Idioma: En Revista: Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido