Incidence of anastomotic leakage using powered circular staplers versus manual circular staplers for left colorectal anastomosis: a cost-effectiveness analysis,Techniques in Coloproctology

当前位置： X-MOL 学术 › Tech. Coloproctol. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Incidence of anastomotic leakage using powered circular staplers versus manual circular staplers for left colorectal anastomosis: a cost-effectiveness analysis
Techniques in Coloproctology ( IF 2.7 ) Pub Date : 2024-07-02 , DOI: 10.1007/s10151-024-02936-0
V Pla-Martí _{1,

2} , J Martín-Arévalo _{1,

2} , D Moro-Valdezate _{1,

2} , S García-Botello _{1,

2} , L Pérez-Santiago ₁ , I Barrachina-Martinez ₃ , S González-de-Julián ₃ , D Vivas-Consuelo ₃ , A Espí-Macías _{1,

2}

Affiliation

Background

Colorectal anastomotic leakage causes severe consequences for patients and healthcare system as it will lead to increased consumption of hospital resources and costs. Technological improvements in anastomotic devices could reduce the incidence of leakage and its economic impact. The aim of the present study was to assess if the use of a new powered circular stapler is cost-effective.

Method

This observational study included patients undergoing left-sided circular stapled colorectal anastomosis between January 2018 and December 2021. Propensity score matching was carried out to create two comparable groups depending on whether the anastomosis was performed using a manual or powered circular device. The rate of anastomotic leakage, its severity, the consumption of hospital resources, and its cost were the main outcome measures. A cost-effectiveness analysis comparing the powered circular stapler versus manual circular staplers was performed.

Results

A total of 330 patients were included in the study, 165 in each group. Anastomotic leakage rates were significantly different (p = 0.012): 22 patients (13.3%) in the manual group versus 8 patients (4.8%) in the powered group. The effectiveness of the powered stapler and manual stapler was 98.27% and 93.69%, respectively. The average cost per patient in the powered group was €6238.38, compared with €9700.12 in the manual group. The incremental cost-effectiveness ratio was − €74,915.28 per patient without anastomotic complications.

Conclusion

The incremental cost of powered circular stapler compared with manual devices was offset by the savings from lowered incidence and cost of management of anastomotic leaks.

中文翻译：

使用电动圆形吻合器与手动圆形吻合器治疗左结直肠吻合口吻合口的发生率：成本效益分析

背景

结直肠吻合口瘘对患者和医疗保健系统造成严重后果，因为它将导致医院资源和成本的消耗增加。吻合口装置的技术改进可以减少渗漏的发生率及其经济影响。本研究的目的是评估使用新的电动圆形订书机是否具有成本效益。

方法

这项观察性研究包括 2018 年 1 月至 2021 年 12 月期间接受左侧圆形吻合结直肠吻合术的患者。进行倾向评分匹配以创建两个可比较的组，具体取决于吻合是使用手动还是电动循环设备进行的。吻合口瘘的发生率、严重程度、医院资源的消耗和成本是主要的结局指标。进行了比较电动圆形吻合器与手动圆形吻合器的成本效益分析。

结果

研究共纳入 330 名患者，每组 165 名。吻合口瘘率存在显著差异（p = 0.012）：手动组 22 例患者（13.3%）与动力组 8 例患者（4.8%）。电动吻合器和手动吻合器的有效性分别为 98.27% 和 93.69%。动力组每位患者的平均费用为 6238.38 欧元，而手动组为 9700.12 欧元。增量成本效益比为 -74,915.28 欧元/例无吻合口并发症的患者。