Palliation of inoperable malignant colonic obstruction.Comparison and cost effectiveness analysis between stent placement and stoma creation

 
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Annals of Gastroenterology
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Palliation of inoperable malignant colonic obstruction.Comparison and cost effectiveness analysis between stent placement and stoma creation (EN)

T. Theodosopoulos, K. Tsamakidis, I. Paraskevas,P. Vassilopoulos, E. Paraskevas, D. Xinopoulos, D. Dimitroulopoulos,

SUMMARY Aim: Comparison of efficacy, safety and cost of palliative endoscopic treatment with auto-expanding metal stents with the stoma creation in the management of patients with inoperable malignant colonic obstructions. Method: Thirty patients with inoperable (metastases, hemodynamic or pulmonary instability) malignant partial obstruction in the left colon due to colorectal or ovarian cancer were included in the study. Fifteen were randomized to undergo palliative metallic colonic stent placement and 15 to undergo stoma creation. The efficacy and safety of each method was compared and cost-effectiveness analysis was performed, including the cost of post-interventional care. Results: Stents were placed successfully in 14 of 15 patients. In one case with obstruction of a tortuous rectosigmoid flexure, colon stenting was not possible. The patient was excluded from the study. During follow up, a moderate nonocclusive ingrowth of tumor into the stent lumen was observed in 6 patients, who were treated with introspective laser application. The performed cost-effectiveness analysis showed that although the stoma creation procedure was less expensive, the total average difference in cost between the two methods was 6.9% (132 Euros). Conclusions: Selfexpanding metallic stent placement is a palliative method, alternative to colostomy, for patients with inoperable malignant colonic strictures, which additionally provides a better quality of life without the psychological repercussions of a colostomy and appears to be cost-effective. Key words: Self-expanding metal stents, Inoperable malignant colonic obstructions, Cost-effectiveness analysis, Colostomy (EN)

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Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Society of Gastroenterology (EN)

2007-03-19


Hellenic Society of Gastroenterology (EN)

1792-7463
1108-7471
Annals of Gastroenterology; Volume 17, No 3 (2004) (EN)



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