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Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study
INTRODUCTION: The goal of modern medical treatment is to provide high quality medical care in a cost-effective environment. AIM: To assess the cost-effectiveness of laparoscopic colorectal surgery combined with the enhanced recovery after surgery protocol (ERP) in Poland. MATERIAL AND METHODS: We de...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840186/ https://www.ncbi.nlm.nih.gov/pubmed/28133495 http://dx.doi.org/10.5114/wiitm.2016.58617 |
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author | Pędziwiatr, Michał Wierdak, Mateusz Nowakowski, Michał Pisarska, Magdalena Stanek, Maciej Kisielewski, Michał Matłok, Maciej Major, Piotr Kłęk, Stanisław Budzyński, Andrzej |
author_facet | Pędziwiatr, Michał Wierdak, Mateusz Nowakowski, Michał Pisarska, Magdalena Stanek, Maciej Kisielewski, Michał Matłok, Maciej Major, Piotr Kłęk, Stanisław Budzyński, Andrzej |
author_sort | Pędziwiatr, Michał |
collection | PubMed |
description | INTRODUCTION: The goal of modern medical treatment is to provide high quality medical care in a cost-effective environment. AIM: To assess the cost-effectiveness of laparoscopic colorectal surgery combined with the enhanced recovery after surgery protocol (ERP) in Poland. MATERIAL AND METHODS: We designed a single-centre, case-matched study. Economic and clinical data were collected in 3 groups of patients (33 patients in each group): group 1 – patients undergoing laparoscopy with ERP; group 2 – laparoscopy without ERP; group 3 – open resection without ERP. An independent administrative officer, not involved in the treatment process, matched patients for age, sex and type of resection. Primary outcome was cost analysis. It was carried out incorporating institutional costs: hospital bed stay, anaesthesia, surgical procedure and equipment, drugs and complications. Secondary outcomes were length of stay (LOS), readmission and complication rate. RESULTS: Cost of laparoscopic procedure alone was significantly more expensive than open resection. However, implementation of the ERAS protocol reduced additional costs. Total cost per patient in group 1 was significantly lower than in groups 2 and 3 (EUR 1826 vs. EUR 2355.3 vs. EUR 2459.5, p < 0.0001). Median LOS was 3, 6 and 9 days in groups 1, 2 and 3 respectively (p < 0.001). Postoperative complications were noted in 5 (15.2%), 6 (18.2%) and 13 (39.4%) patients in groups 1, 2, 3 respectively (p = 0.0435). CONCLUSIONS: In a low medical care expenditure country, minimally invasive surgery combined with ERP can be a safe and a cost-effective alternative to open surgery with traditional perioperative care. |
format | Online Article Text |
id | pubmed-4840186 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-48401862017-01-27 Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study Pędziwiatr, Michał Wierdak, Mateusz Nowakowski, Michał Pisarska, Magdalena Stanek, Maciej Kisielewski, Michał Matłok, Maciej Major, Piotr Kłęk, Stanisław Budzyński, Andrzej Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: The goal of modern medical treatment is to provide high quality medical care in a cost-effective environment. AIM: To assess the cost-effectiveness of laparoscopic colorectal surgery combined with the enhanced recovery after surgery protocol (ERP) in Poland. MATERIAL AND METHODS: We designed a single-centre, case-matched study. Economic and clinical data were collected in 3 groups of patients (33 patients in each group): group 1 – patients undergoing laparoscopy with ERP; group 2 – laparoscopy without ERP; group 3 – open resection without ERP. An independent administrative officer, not involved in the treatment process, matched patients for age, sex and type of resection. Primary outcome was cost analysis. It was carried out incorporating institutional costs: hospital bed stay, anaesthesia, surgical procedure and equipment, drugs and complications. Secondary outcomes were length of stay (LOS), readmission and complication rate. RESULTS: Cost of laparoscopic procedure alone was significantly more expensive than open resection. However, implementation of the ERAS protocol reduced additional costs. Total cost per patient in group 1 was significantly lower than in groups 2 and 3 (EUR 1826 vs. EUR 2355.3 vs. EUR 2459.5, p < 0.0001). Median LOS was 3, 6 and 9 days in groups 1, 2 and 3 respectively (p < 0.001). Postoperative complications were noted in 5 (15.2%), 6 (18.2%) and 13 (39.4%) patients in groups 1, 2, 3 respectively (p = 0.0435). CONCLUSIONS: In a low medical care expenditure country, minimally invasive surgery combined with ERP can be a safe and a cost-effective alternative to open surgery with traditional perioperative care. Termedia Publishing House 2016-03-16 2016-03 /pmc/articles/PMC4840186/ /pubmed/28133495 http://dx.doi.org/10.5114/wiitm.2016.58617 Text en Copyright © 2016 Sekcja Wideochirurgii TChP http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Pędziwiatr, Michał Wierdak, Mateusz Nowakowski, Michał Pisarska, Magdalena Stanek, Maciej Kisielewski, Michał Matłok, Maciej Major, Piotr Kłęk, Stanisław Budzyński, Andrzej Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study |
title | Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study |
title_full | Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study |
title_fullStr | Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study |
title_full_unstemmed | Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study |
title_short | Cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (ERAS) protocol: a single-centre, case-matched study |
title_sort | cost minimization analysis of laparoscopic surgery for colorectal cancer within the enhanced recovery after surgery (eras) protocol: a single-centre, case-matched study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840186/ https://www.ncbi.nlm.nih.gov/pubmed/28133495 http://dx.doi.org/10.5114/wiitm.2016.58617 |
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