BACKGROUND: Few studies have compared the costs of colorectal endoscopic submucosal dissection (ESD) and endoscopic piecemeal mucosal resection (EPMR). AIMS: Here, we aimed to investigate the cost-effectiveness of these approaches by analyzing clinical outcomes and costs. METHODS: Data from patients undergoing colorectal ESD and EPMR were retrospectively reviewed. Clinical outcomes (procedure time, complete resection, and recurrence) were compared, and total direct costs (procedural and follow-up) were assessed. RESULTS: Data from 429 ESD and 115 EPMR patients were included in the analysis. The complete resection rate was significantly higher (83.9% vs. 32.2%, p < 0.001), recurrence rate was lower (0.5% vs. 7.1%, p < 0.001), procedure time was longer (55.4 ± 47.0 vs. 25.6 ± 32.7 min, p < 0.001), and total direct procedural costs at the initial resection were higher (1480.0 ± 728.0 vs. 729.8 ± 299.7 USD, p < 0.001) in the ESD group than in the EPMR group. The total number of surveillance endoscopies was higher in the EPMR group (1.7 ± 1.5 vs. 1.3 ± 1.1, p = 0.003). The cumulative total costs of ESD and EPMR were comparable at 3 and 2 years' follow-up in the adenoma and mucosal/superficial submucosal cancer subgroups, respectively. CONCLUSIONS: Colorectal ESD was associated with higher complete resection and lower recurrence rates. EPMR showed shorter procedure times and similar cumulative total direct costs. ESD or EPMR should be chosen based on both clinical outcomes and cost-effectiveness.
BACKGROUND: Few studies have compared the costs of colorectal endoscopic submucosal dissection (ESD) and endoscopic piecemeal mucosal resection (EPMR). AIMS: Here, we aimed to investigate the cost-effectiveness of these approaches by analyzing clinical outcomes and costs. METHODS: Data from patients undergoing colorectal ESD and EPMR were retrospectively reviewed. Clinical outcomes (procedure time, complete resection, and recurrence) were compared, and total direct costs (procedural and follow-up) were assessed. RESULTS: Data from 429 ESD and 115 EPMR patients were included in the analysis. The complete resection rate was significantly higher (83.9% vs. 32.2%, p < 0.001), recurrence rate was lower (0.5% vs. 7.1%, p < 0.001), procedure time was longer (55.4 ± 47.0 vs. 25.6 ± 32.7 min, p < 0.001), and total direct procedural costs at the initial resection were higher (1480.0 ± 728.0 vs. 729.8 ± 299.7 USD, p < 0.001) in the ESD group than in the EPMR group. The total number of surveillance endoscopies was higher in the EPMR group (1.7 ± 1.5 vs. 1.3 ± 1.1, p = 0.003). The cumulative total costs of ESD and EPMR were comparable at 3 and 2 years' follow-up in the adenoma and mucosal/superficial submucosal cancer subgroups, respectively. CONCLUSIONS:Colorectal ESD was associated with higher complete resection and lower recurrence rates. EPMR showed shorter procedure times and similar cumulative total direct costs. ESD or EPMR should be chosen based on both clinical outcomes and cost-effectiveness.
Authors: Shin ei Kudo; René Lambert; John I Allen; Hiroaki Fujii; Takahiro Fujii; Hiroshi Kashida; Takahisa Matsuda; Masaki Mori; Hiroshi Saito; Tadakazu Shimoda; Shinji Tanaka; Hidenobu Watanabe; Joseph J Sung; Andrew D Feld; John M Inadomi; Michael J O'Brien; David A Lieberman; David F Ransohoff; Roy M Soetikno; George Triadafilopoulos; Ann Zauber; Claudio Rolim Teixeira; Jean François Rey; Edgar Jaramillo; Carlos A Rubio; Andre Van Gossum; Michael Jung; Michael Vieth; Jeremy R Jass; Paul D Hurlstone Journal: Gastrointest Endosc Date: 2008-10 Impact factor: 9.427
Authors: Monika Ferlitsch; Alan Moss; Cesare Hassan; Pradeep Bhandari; Jean-Marc Dumonceau; Gregorios Paspatis; Rodrigo Jover; Cord Langner; Maxime Bronzwaer; Kumanan Nalankilli; Paul Fockens; Rawi Hazzan; Ian M Gralnek; Michael Gschwantler; Elisabeth Waldmann; Philip Jeschek; Daniela Penz; Denis Heresbach; Leon Moons; Arnaud Lemmers; Konstantina Paraskeva; Juergen Pohl; Thierry Ponchon; Jaroslaw Regula; Alessandro Repici; Matthew D Rutter; Nicholas G Burgess; Michael J Bourke Journal: Endoscopy Date: 2017-02-17 Impact factor: 10.093
Authors: Farzan F Bahin; Steven J Heitman; Khalid N Rasouli; Hema Mahajan; Duncan McLeod; Eric Y T Lee; Stephen J Williams; Michael J Bourke Journal: Gut Date: 2017-10-07 Impact factor: 23.059
Authors: Ryan Law; Ananya Das; Dyanna Gregory; Srinadh Komanduri; Raman Muthusamy; Amit Rastogi; John Vargo; Michael B Wallace; G S Raju; Rawad Mounzer; Jason Klapman; Janak Shah; Rabindra Watson; Robert Wilson; Steven A Edmundowicz; Sachin Wani Journal: Gastrointest Endosc Date: 2015-12-01 Impact factor: 9.427