The Cost Effectiveness of Colonic Stenting As a Bridge to Curative Surgery in Patients with Acute Left-Sided Malignant Colonic Obstruction: A Canadian Perspective

Singh, Harminder; Targownik, Laura E.; Latosinsky, Steven; Spiegel, Brennan M.

doi:10.1016/j.gie.2006.03.094

Cited by 9 publications

(13 citation statements)

References 15 publications

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“…Prior decompression by SEMS followed by laparoscopic resection is currently the preferred approach for patients with left‐sided colonic obstruction in our institution. Various studies have demonstrated that SEMS is more cost‐effective and more efficient than emergency surgery [23–27]. This is because of the longer hospital stay, or even intensive care, that are often required by those requiring emergency surgery, who have a much higher chance of developing postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Self-expanding metallic stents for acute left-sided large-bowel obstruction: a review of 130 patients

2011

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Section: Discussionmentioning

confidence: 99%

Self-expanding metallic stents for acute left-sided large-bowel obstruction: a review of 130 patients

2011

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“…Nevertheless insertion of SEMS for acute malignant colonic obstruction was associated with lower mortality rates, a lower mean number of operations per patient, and a reduction in the number of permanent and temporary stomas required compared with either emergency resective surgery or emergency diverting colostomy. Though the cost associated with colonic stenting is higher than the cost of performing a diverting colostomy for the initial management of acute, malignant colonic obstruction, the incremental cost associated with providing one additional improved patient outcome is very reasonable [13].…”

Section: Discussionmentioning

confidence: 99%

Self-Expanding Metal Stenting for Malignant Colonic Tumours: A Prospective Study

Al-Jundi¹,

Kadam²,

Giagtzidis³

et al. 2011

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Background: Self-expanding metal stents (SEMS) have been used in the management of malignant colorectal obstruction for palliation or as a bridging tool to single-stage surgery. We present the clinical results of a series of patients with colonic cancer in whom SEMS were inserted endoscopically under radiological guidance. Methods: Between September 2007 and January 2010, prospectively collected data from 21 patients who underwent SEMS insertion was analysed. This data includes demographics, indication for stenting, stent size, technical success, clinical success, complications, survival and duration of hospitalisation. Results: 14 male and 7 female patients with malignant colonic obstruction underwent SEMS insertion: 19 requiring palliation and 2 bridging to surgery. The rate of technical success was 100% and of initial clinical success was 100%. In 16/19 (84.2%) of the palliation group, clinical success was maintained at mean follow up of 3.4 months (1-6 months), while 3/19 (15.8%) died, two with functioning stents and one with stent occlusion. The two patients with operable tumours were successfully bridged to one-stage elective surgery at 1 month and 4 months following stenting. Post-procedure complications occurred in 5 patients: 1 perforation, 2 pain, 1 migration and 1 stent occlusion. All patients were discharged alive and the median hospital stay was 1 day (range: 1 to 13 days). Conclusion: SEMS provides an effective and safe option in the palliation of malignant colorectal obstruction. In operable patients, it provides a useful option to avoid colostomy, by facilitating safer single-stage surgery. In this prospective study of SEMS insertion, high rates of technical and initial clinical success were achieved. This could be attributed to performing the procedure under combined endoscopic and radiological guidance

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“…In Baque et al [ 41 ], global mean hospital stay was longer in the colostomy group (32.7 days vs. 19.3 days, P = 0.02). In Singh et al [ 42 ], the incremental cost-effectiveness ratio associated with the use of colonic stenting followed by elective surgery versus diverting colostomy was $1,415 to prevent a temporary stoma, $1,516 to prevent an additional operation, and $15,734 to prevent an additional death.…”

Section: Cost-effectivenessmentioning

confidence: 99%

Advanced Colonoscopy

2014

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The Cost Effectiveness of Colonic Stenting As a Bridge to Curative Surgery in Patients with Acute Left-Sided Malignant Colonic Obstruction: A Canadian Perspective

Cited by 9 publications

References 15 publications

Self-expanding metallic stents for acute left-sided large-bowel obstruction: a review of 130 patients

Self-expanding metallic stents for acute left-sided large-bowel obstruction: a review of 130 patients

Self-Expanding Metal Stenting for Malignant Colonic Tumours: A Prospective Study

Advanced Colonoscopy

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