Cost-effectiveness of endoscopically placed stents in the palliation of locally advanced esophageal carcinoma.
The study assessed 50 consecutive patients presenting advanced esophageal carcinoma, in order to evaluate the cost-effectiveness of endoscopic palliation of dysphagia. Cases were divided into groups according to the type of therapy: Group A - surgical resections; Group B - gastrostomy, jejunostomy, surgical bypass or no palliation; Group C - endoscopic palliation. A retrospective study analysed early mortality, length of hospital stay and cost of therapy. Mean postoperative survival was within the expected limits in the endoscopically treated group (3-6 months), and in the non-resected group, while resected patients showed a very high early mortality and no long term survivals. Costs were significantly smaller in Group C as compared with Group A, with shorter hospital stay and better palliation. We conclude that endoscopically placed stents represent a cost effective palliation for advanced esophageal carcinoma and medical authorities should consider covering the expenses required by such procedures.
Dimofte
Gabriel
G
1st Surgical Clinic, St. Spiridon Hospital, Bd. Independentei no.1, 6600 Iasi, Romania.
Crumpei
Felicia
F
Trifina
Liviu
L
Nicolescu
Simona
S
Leanca
Dan
D
D000230:Adenocarcinoma / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003680:Deglutition Disorders / Q000209:etiology / Q000628:therapy; D004724:Endoscopy / Q000191:economics* / Q000379:methods*; D004938:Esophageal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D004940:Esophageal Stenosis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000191:economics* / Q000379:methods; D015607:Stents; D016896:Treatment Outcome