D J Nijssen, K Wienholts, M J Postma, W A Bemelman, J Tuynman, W Laméris, P J Tanis, R Hompes
{"title":"全直肠系膜切除术后吻合口漏不同治疗策略的住院费用：一项多中心成本分析","authors":"D J Nijssen, K Wienholts, M J Postma, W A Bemelman, J Tuynman, W Laméris, P J Tanis, R Hompes","doi":"10.1007/s10151-025-03215-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on hospital costs incurred by anastomotic leakage (AL), particularly in relation to specific treatment approaches. This study aimed to analyse the incremental hospital costs of AL after total mesorectal excision (TME), stratified by treatment strategy, over a 1-year time horizon.</p><p><strong>Methods: </strong>Patients undergoing total mesorectal excision (TME) for rectal cancer (2020-2023), included in the control cohort of the IMARI-study at 15 Dutch centres, were analysed. A cost analysis was conducted according to Dutch National Healthcare Institute guidelines. The primary outcome was the incremental hospital costs incurred by patients with AL detected within 30 days postoperatively, stratified by treatment strategy.</p><p><strong>Results: </strong>The analysis compared treatment costs in 32 patients with AL and 82 patients without AL. The average hospital costs per patient in the first postoperative year were €15.312. In patients with AL, the mean incremental costs were €24.333. Major cost drivers in the AL group were prolonged hospitalization (+€13.150) and (re)interventions (+€8.910). The treatment costs differed significantly between strategies: no faecal diversion (€10.062), faecal diversion with passive drainage (€23.903), faecal diversion with active drainage (€35.552), and salvage surgery (€38.793).</p><p><strong>Conclusions: </strong>AL after TME resulted in a nearly fourfold increase in hospital costs compared with patients without AL. Salvage surgery was the most expensive treatment strategy, followed by faecal diversion with active drainage. Future studies should evaluate how these treatment costs relate to clinical success rates, including rates of chronic pelvic sepsis and permanent stomas.</p><p><strong>Trial registration: </strong>This study used data from the IMARI-study. The IMARI-study is registered with the Dutch Central Committee on Research Involving Human Subjects (NL67600.018.18) and is submitted to the http://www.onderzoekmetmensen.nl/en database (NL-OMON26456 and NL-OMON55903).</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"173"},"PeriodicalIF":2.9000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hospital costs of different treatment strategies for anastomotic leakage after total mesorectal excision: a multicentre cost analysis.\",\"authors\":\"D J Nijssen, K Wienholts, M J Postma, W A Bemelman, J Tuynman, W Laméris, P J Tanis, R Hompes\",\"doi\":\"10.1007/s10151-025-03215-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Limited data exist on hospital costs incurred by anastomotic leakage (AL), particularly in relation to specific treatment approaches. This study aimed to analyse the incremental hospital costs of AL after total mesorectal excision (TME), stratified by treatment strategy, over a 1-year time horizon.</p><p><strong>Methods: </strong>Patients undergoing total mesorectal excision (TME) for rectal cancer (2020-2023), included in the control cohort of the IMARI-study at 15 Dutch centres, were analysed. A cost analysis was conducted according to Dutch National Healthcare Institute guidelines. The primary outcome was the incremental hospital costs incurred by patients with AL detected within 30 days postoperatively, stratified by treatment strategy.</p><p><strong>Results: </strong>The analysis compared treatment costs in 32 patients with AL and 82 patients without AL. The average hospital costs per patient in the first postoperative year were €15.312. In patients with AL, the mean incremental costs were €24.333. Major cost drivers in the AL group were prolonged hospitalization (+€13.150) and (re)interventions (+€8.910). The treatment costs differed significantly between strategies: no faecal diversion (€10.062), faecal diversion with passive drainage (€23.903), faecal diversion with active drainage (€35.552), and salvage surgery (€38.793).</p><p><strong>Conclusions: </strong>AL after TME resulted in a nearly fourfold increase in hospital costs compared with patients without AL. Salvage surgery was the most expensive treatment strategy, followed by faecal diversion with active drainage. Future studies should evaluate how these treatment costs relate to clinical success rates, including rates of chronic pelvic sepsis and permanent stomas.</p><p><strong>Trial registration: </strong>This study used data from the IMARI-study. The IMARI-study is registered with the Dutch Central Committee on Research Involving Human Subjects (NL67600.018.18) and is submitted to the http://www.onderzoekmetmensen.nl/en database (NL-OMON26456 and NL-OMON55903).</p>\",\"PeriodicalId\":51192,\"journal\":{\"name\":\"Techniques in Coloproctology\",\"volume\":\"29 1\",\"pages\":\"173\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Coloproctology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10151-025-03215-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-025-03215-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Hospital costs of different treatment strategies for anastomotic leakage after total mesorectal excision: a multicentre cost analysis.
Background: Limited data exist on hospital costs incurred by anastomotic leakage (AL), particularly in relation to specific treatment approaches. This study aimed to analyse the incremental hospital costs of AL after total mesorectal excision (TME), stratified by treatment strategy, over a 1-year time horizon.
Methods: Patients undergoing total mesorectal excision (TME) for rectal cancer (2020-2023), included in the control cohort of the IMARI-study at 15 Dutch centres, were analysed. A cost analysis was conducted according to Dutch National Healthcare Institute guidelines. The primary outcome was the incremental hospital costs incurred by patients with AL detected within 30 days postoperatively, stratified by treatment strategy.
Results: The analysis compared treatment costs in 32 patients with AL and 82 patients without AL. The average hospital costs per patient in the first postoperative year were €15.312. In patients with AL, the mean incremental costs were €24.333. Major cost drivers in the AL group were prolonged hospitalization (+€13.150) and (re)interventions (+€8.910). The treatment costs differed significantly between strategies: no faecal diversion (€10.062), faecal diversion with passive drainage (€23.903), faecal diversion with active drainage (€35.552), and salvage surgery (€38.793).
Conclusions: AL after TME resulted in a nearly fourfold increase in hospital costs compared with patients without AL. Salvage surgery was the most expensive treatment strategy, followed by faecal diversion with active drainage. Future studies should evaluate how these treatment costs relate to clinical success rates, including rates of chronic pelvic sepsis and permanent stomas.
Trial registration: This study used data from the IMARI-study. The IMARI-study is registered with the Dutch Central Committee on Research Involving Human Subjects (NL67600.018.18) and is submitted to the http://www.onderzoekmetmensen.nl/en database (NL-OMON26456 and NL-OMON55903).
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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