结肠镜辅助腹腔镜切除与细分结肠切除良性结肠多瘤:一个比较成本分析
Julia Hanevelt1, Laura W Leicher1, Leon M G Moons2
1Department of Gastroenterology and Hepatology, Isala, Zwolle, The Netherlands.
概括
结肠镜辅助腹腔镜切除 (CAL-WR) 为复杂的多重体提供了一种成本效益高且更安全的替代方案,而不是细分结肠切除 (SCR). 这种微创手术方法显著减少并发症,手术时间和住院时间,从而大大节省成本.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 最少侵入性手术的方法
- 胃肠病学 胃肠病学
背景情况:
- 大型或复杂的良性结肠多通常需要手术干预,当内镜切除是不可行的.
- 分段结肠切除 (SCR) 是这种病例的传统手术方法.
- 结肠镜辅助腹腔镜切除 (CAL-WR) 已经成为一种潜在的更有效和更安全的替代方案.
研究的目的:
- 评估与CAL-WR相关的成本.
- 为了比较CAL-WR的成本与SCR对良性结肠的成本.
- 评估CAL-WR的临床和财务效益.
主要方法:
- 一个单一中心,90天住院的比较成本分析.
- 从前性研究中接受CAL-WR (n=44) 的患者与接受选择性SCR (n=32) 的患者进行了回顾性比较.
- 对CAL-WR的纳入标准包括内镜无法切除的息肉,残留/复发的息肉,或非彻底切除的低风险pT1结肠癌.
主要成果:
- 在CAL-WR中,并发症显著减少 (7%与45%,P<0.001).
- 使用CAL-WR的操作时间较短 (50分钟对119分钟,P<0.001).
- 住院时间较短 (2天比4天,P<0.001),手术资源成本降低了32%,每位患者节省了2372欧元.
结论:
- CAL-WR与显著的临床益处有关,包括减少并发症和缩短恢复时间.
- 与SCR相比,该程序可以大幅节省成本.
- 在考虑重大手术之前,应建议CAL-WR用于不适合内镜切除的复杂良性息肉.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
97
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
97
Inflammatory Bowel Disease V: Surgical Management
161
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
161
Endoscopic Procedures II: Colonoscopy
112
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
112


