PDF(Pubmed)
Abstract：
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.
METHODS: 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.
CONCLUSIONS: 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.
METHODS: 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.
CONCLUSIONS: 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.
摘要：
背景：结肠直肠吻合口漏会对患者和医疗保健系统造成严重后果，因为它会导致医院资源和成本的消耗增加。吻合装置的技术改进可以减少泄漏的发生率及其经济影响。本研究的目的是评估使用新型动力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月接受左侧环形吻合术的患者。根据吻合是使用手动还是动力循环装置进行,进行倾向评分匹配以创建两个可比较的组。吻合口漏的发生率,其严重性,医院资源的消耗，其成本是主要的结果衡量标准。进行了比较动力圆形订书机与手动圆形订书机的成本效益分析。
结果：共有330名患者被纳入研究，每组165。吻合口漏率显着不同（p=0.012）：手动组22例（13.3％）与动力组8例（4.8％）。动力订书机和手动订书机的有效率分别为98.27%和93.69%,分别。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。增加的成本效益比为-每例无吻合口并发症的患者为-74,915.28欧元。
结论：与手动设备相比，电动圆形吻合器的成本增加被吻合口瘘发生率降低和管理成本所节省的成本所抵消。
方法：这项观察性研究包括2018年1月至2021年12月接受左侧环形吻合术的患者。根据吻合是使用手动还是动力循环装置进行,进行倾向评分匹配以创建两个可比较的组。吻合口漏的发生率,其严重性,医院资源的消耗，其成本是主要的结果衡量标准。进行了比较动力圆形订书机与手动圆形订书机的成本效益分析。
结果：共有330名患者被纳入研究，每组165。吻合口漏率显着不同（p=0.012）：手动组22例（13.3％）与动力组8例（4.8％）。动力订书机和手动订书机的有效率分别为98.27%和93.69%,分别。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。增加的成本效益比为-每例无吻合口并发症的患者为-74,915.28欧元。
结论：与手动设备相比，电动圆形吻合器的成本增加被吻合口瘘发生率降低和管理成本所节省的成本所抵消。
