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Cost-effectiveness of self-expandable metallic stents as bridge to surgery for obstructive colorectal cancer

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Abstract

Aim

Self-expandable metallic stent (SEMS) placement is an emergent decompression approach for patients with obstructive colorectal cancer, alongside drainage tube (DT) and emergency surgery (ES). Few reports have compared the health care cost of each treatment. We aimed to compare the efficacy of SEMS as a bridge to surgery (BTS), including health care costs during decompression and colorectal resection, with those of DT and ES.

Methods

This retrospective study enrolled patients treated for acute obstructed colorectal cancer at a single institution from January 2007 to December 2019. A total of 45 patients that underwent placement of a DT, emergency colostomy, or SEMS insertion followed by elective radical colectomy or rectectomy for obstructed colorectal cancer were included, and their data were analyzed.

Results

Among 45 patients with obstructive colorectal cancer, 29 (55.6%) patients underwent SEMS, 7 (15.6%) underwent DT, and 9 (20.0%) underwent ES as BTS. The time to oral intake from the decompression treatment in the SEMS group was significantly shorter than that of the DT and ES group (1 vs. 13 vs. 3 day, p < 0.001). Total hospitalization during the decompression and colorectal resection in the SEMS group was significantly shorter that in the DT and ES groups (23 vs. 34 vs. 44 day, p < 0.001). The total health care cost for the decompression and the colorectal resection of DT and SEMS treatment was significantly less inexpensive than ES treatment (180.8 vs. 206.7 vs. 250.3 × 104 yen, p = 0.030).

Conclusions

SEMS insertion as a BTS might represent a cost-effective and safe approach compared to other treatments.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English editing.

Funding

None.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Japan

    Takayoshi Kaida, Koichi Doi, Shinsei Yumoto, Shotaro Kinoshita & Hiroyuki Ishiodori

  2. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto, 860-8556, Japan

    Takayoshi Kaida, Shotaro Kinoshita, Hideaki Takeyama & Hideo Baba

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  1. Takayoshi Kaida
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  2. Koichi Doi
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  3. Shinsei Yumoto
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Contributions

TK was the chief investigator and also responsible for the data analysis. All authors contributed to the writing of the final manuscript. All members of this study contributed to the management of the study.

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Correspondence to Takayoshi Kaida.

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Kaida, T., Doi, K., Yumoto, S. et al. Cost-effectiveness of self-expandable metallic stents as bridge to surgery for obstructive colorectal cancer. Int J Clin Oncol 26, 1485–1491 (2021). https://doi.org/10.1007/s10147-021-01928-6

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  • DOI: https://doi.org/10.1007/s10147-021-01928-6

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