Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms
Despite the increasing application of transanal endoscopic microsurgery (TEM) for rectal lesions, the cost of the equipment may play a role in a hospital’s hesitancy to invest in the platform. This study compares the cost of TEM to laparoscopic low anterior resection (LAR). Patients who underwent la...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/28/3/167 |
| _version_ | 1797520779638734848 |
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| author | Katerina Neumann Nirmal Randhawa Jason Park David J. Hochman |
| author_facet | Katerina Neumann Nirmal Randhawa Jason Park David J. Hochman |
| author_sort | Katerina Neumann |
| collection | DOAJ |
| description | Despite the increasing application of transanal endoscopic microsurgery (TEM) for rectal lesions, the cost of the equipment may play a role in a hospital’s hesitancy to invest in the platform. This study compares the cost of TEM to laparoscopic low anterior resection (LAR). Patients who underwent laparoscopic LAR (<i>n</i> = 24) for rectal neoplasm between 2006 and 2014 were case-matched based on sex, age, comorbidities, lesion size and location to patients who underwent TEM at a busy secondary care urban hospital. Procedure-related costs and costs associated with readmissions for complications and related subsequent surgeries in the first 3 years were calculated. There were 42 hospital admissions for 24 LAR patients, totalling 326 hospital days. For 24 TEM patients, there were 25 hospital admissions, totalling 56 hospital days. Subsequent operations for LAR patients included 2 washout and diverting ileostomies (8%), 2 adhesionolysis (8%), 4 ventral hernia repairs (16%) and 11 ileostomy reversals (46%). In the TEM group, there was one operation for recurrence (4%). The mean cost of LAR, including all related hospital costs in the subsequent 3 years, was CAD 14,851 (95% CI: CAD 10,124–19,579). The mean cost of TEM was CAD 2449 (95% CI: CAD 2133–2767; <i>p</i> < 0.0001), with a savings of CAD 12,402 per patient. TEM for rectal neoplasm is associated with significantly lower hospital costs, which far outweigh the costs of acquiring and maintaining the technology. |
| first_indexed | 2024-03-10T08:01:28Z |
| format | Article |
| id | doaj.art-dc11e94d28de459485cd1971e6f7d2bf |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T08:01:28Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-dc11e94d28de459485cd1971e6f7d2bf2023-11-22T11:27:22ZengMDPI AGCurrent Oncology1198-00521718-77292021-05-012831795180210.3390/curroncol28030167Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal NeoplasmsKaterina Neumann0Nirmal Randhawa1Jason Park2David J. Hochman3Division of General Surgery, Dalhousie University, 8-819 Victoria Building, VGH, 1276 South Park Street, Halifax, NS B2H 2Y9, CanadaFaculty of Medicine, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB R3E 0W2, CanadaDivision of General Surgery, Vancouver General Hospital, 5th Floor—2775 Laurel Street, Vancouver, BC V5Z 1M9, CanadaDivision of General Surgery, University of Manitoba, St. Boniface Clinic, 343 Tache Avenue, Winnipeg, MB R2H 2A5, CanadaDespite the increasing application of transanal endoscopic microsurgery (TEM) for rectal lesions, the cost of the equipment may play a role in a hospital’s hesitancy to invest in the platform. This study compares the cost of TEM to laparoscopic low anterior resection (LAR). Patients who underwent laparoscopic LAR (<i>n</i> = 24) for rectal neoplasm between 2006 and 2014 were case-matched based on sex, age, comorbidities, lesion size and location to patients who underwent TEM at a busy secondary care urban hospital. Procedure-related costs and costs associated with readmissions for complications and related subsequent surgeries in the first 3 years were calculated. There were 42 hospital admissions for 24 LAR patients, totalling 326 hospital days. For 24 TEM patients, there were 25 hospital admissions, totalling 56 hospital days. Subsequent operations for LAR patients included 2 washout and diverting ileostomies (8%), 2 adhesionolysis (8%), 4 ventral hernia repairs (16%) and 11 ileostomy reversals (46%). In the TEM group, there was one operation for recurrence (4%). The mean cost of LAR, including all related hospital costs in the subsequent 3 years, was CAD 14,851 (95% CI: CAD 10,124–19,579). The mean cost of TEM was CAD 2449 (95% CI: CAD 2133–2767; <i>p</i> < 0.0001), with a savings of CAD 12,402 per patient. TEM for rectal neoplasm is associated with significantly lower hospital costs, which far outweigh the costs of acquiring and maintaining the technology.https://www.mdpi.com/1718-7729/28/3/167TEMTAMIStransanal endoscopic microsurgeryLARlow anterior resectioncost-analysis |
| spellingShingle | Katerina Neumann Nirmal Randhawa Jason Park David J. Hochman Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms Current Oncology TEM TAMIS transanal endoscopic microsurgery LAR low anterior resection cost-analysis |
| title | Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms |
| title_full | Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms |
| title_fullStr | Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms |
| title_full_unstemmed | Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms |
| title_short | Cost Analysis of Laparoscopic Low Anterior Resection vs. Transanal Endoscopic Microsurgery for Rectal Neoplasms |
| title_sort | cost analysis of laparoscopic low anterior resection vs transanal endoscopic microsurgery for rectal neoplasms |
| topic | TEM TAMIS transanal endoscopic microsurgery LAR low anterior resection cost-analysis |
| url | https://www.mdpi.com/1718-7729/28/3/167 |
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