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Costs and resource use following defunctioning stoma in low anterior resection for cancer: A long-term analysis of a randomized multicenter trial
Orebro University Hospital. Department of Surgery.
Department of Surgery, Linköping University Hospital, Linköping, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Örebro University, School of Health Sciences. Orebro University Hospital. Center for Health Care Science, Örebro County Council, Örebro, Sweden.
Orebro University Hospital. Department of Surgery.
2017 (English)In: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 43, no 2, 330-336 p.Article in journal (Refereed) Published
Abstract [en]

Background: Defunctioning stoma in low anterior resection (LAR) for rectal cancer can prevent major complications, but overall cost-effectiveness for the healthcare provider is unknown. This study compared inpatient healthcare resources and costs within 5 years of LAR between two randomized groups of patients undergoing LAR with and without defunctioning stoma.

Method: Five-year follow-up of a randomized, multicenter trial on LAR (NCT 00636948) with (stoma; n = 116) or without (no stoma; n = 118) defunctioning stoma comparing inpatient healthcare resources and costs. Unplanned stoma formation, days with stoma, length of hospital stay, reoperations, and total associated inpatient costs were analyzed.

Results: Average costs were (sic) 21.663 per patient with defunctioning stoma and (sic) 15.922 per patient without defunctioning stoma within 5 years of LAR, resulting in an average cost-saving of (sic) 5.741. There was no difference between groups regarding the total number of days with any stoma (stoma = 33 398 vs. no stoma = 34 068). The total number of unplanned reoperations were 70 (no stoma) and 32 (stoma); p < 0.001. In the group randomized to no stoma at LAR, 30.5% (36/118) required an unplanned stoma later.

Conclusion: Randomization to defunctioning stoma in LAR was more expensive than no stoma, despite the cost-savings associated with a reduced frequency of anastomotic leakage. Both groups required the same total number of days with a stoma within five years of LAR. (C) 2016 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 43, no 2, 330-336 p.
Keyword [en]
Rectal cancer, Defunctioning stoma, Costs and cost analysis, Health resources, Anastomotic leak
National Category
Cancer and Oncology Surgery
Identifiers
URN: urn:nbn:se:oru:diva-56994DOI: 10.1016/j.ejso.2016.12.003ISI: 000394072300013PubMedID: 28069399Scopus ID: 2-s2.0-85008640146OAI: oai:DiVA.org:oru-56994DiVA: diva2:1087886
Note

Funding Agency:

Örebro County Council, Örebro, Sweden  OLL-326961  OLL-500101

Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2017-04-10Bibliographically approved

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Floodeen, HannahHagberg, Lars A.Matthiessen, Peter
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