Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum
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 un...
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| Veröffentlicht in: | Digestive diseases and sciences 2020-04, Vol.65 (4), p.969-977 |
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| creator | Ham, Nam Seok Kim, Jeongseok Oh, Eun Hye Hwang, Sung Wook Park, Sang Hyoung Yang, Dong-Hoon Ye, Byong Duk Myung, Seung-Jae Yang, Suk-Kyun Byeon, Jeong-Sik |
| description | 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
|
| doi_str_mv | 10.1007/s10620-019-05822-0 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_cross</sourceid><recordid>TN_cdi_gale_infotracacademiconefile_A712934748</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A712934748</galeid><sourcerecordid>A712934748</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-b4ad5288407afd58bf0b3626dd5dc4c4412fdbcc6522a80c0207dc7a96a9ec03</originalsourceid><addsrcrecordid>eNqN0VFr1TAYBuAgijtO_4AXUvBGkM4vaZI2l6NuKkwUHd6GNPm6ZbTNMWkR__3SnbM5RURykRCeN3ztS8hzCkcUoH6TKEgGJVBVgmgYK-EB2VBRVyUTsnlINkBlPlMqD8iTlK4AQNVUPiYHFeWqAk435LINaS5CX5xMLiQbtt4WX5duXGxIZije-pTQzj5MxTeMaUn33WePFkfM7OOef8Fb7adivsSiDUOI-WoZn5JHvRkSPtvvh-T89OS8fV-efXr3oT0-Ky3nbC47bpxgTcOhNr0TTddDV0kmnRPO8mwo611nrRSMmQYsMKidrY2SRqGF6pC82j27jeH7gmnWo08Wh8FMGJakGWukYkBFk-nLP-hVWOKUh1uV4LSq-D11YQbUfurDHI1dH9XHNWWq4vWNOvqLysvh6G2YsPf5_rcA2wVsDClF7PU2-tHEn5qCXtvVu3Z1blfftKvXj3uxnzg3hO4ucltnBs0O_MAu9Ml6nCzesdy_oIpzpfKJstbPZu2qDcs05-jr_49mXe10ymK6wPjr3_1j_mtr1s85</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2285413348</pqid></control><display><type>article</type><title>Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum</title><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>SpringerLink Journals - AutoHoldings</source><creator>Ham, Nam Seok ; Kim, Jeongseok ; Oh, Eun Hye ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong-Hoon ; Ye, Byong Duk ; Myung, Seung-Jae ; Yang, Suk-Kyun ; Byeon, Jeong-Sik</creator><creatorcontrib>Ham, Nam Seok ; Kim, Jeongseok ; Oh, Eun Hye ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong-Hoon ; Ye, Byong Duk ; Myung, Seung-Jae ; Yang, Suk-Kyun ; Byeon, Jeong-Sik</creatorcontrib><description>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.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-019-05822-0</identifier><identifier>PMID: 31493041</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Biochemistry ; Cancer ; Clinical outcomes ; Colorectal cancer ; Comparative analysis ; Cost analysis ; Economic aspects ; Endoscopy ; Gastroenterology ; Gastroenterology & Hepatology ; Hepatology ; Life Sciences & Biomedicine ; Medical colleges ; Medicine ; Medicine & Public Health ; Oncology ; Oncology, Experimental ; Original Article ; Science & Technology ; Surgery ; Transplant Surgery</subject><ispartof>Digestive diseases and sciences, 2020-04, Vol.65 (4), p.969-977</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Digestive Diseases and Sciences is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>11</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000519449900012</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c442t-b4ad5288407afd58bf0b3626dd5dc4c4412fdbcc6522a80c0207dc7a96a9ec03</citedby><cites>FETCH-LOGICAL-c442t-b4ad5288407afd58bf0b3626dd5dc4c4412fdbcc6522a80c0207dc7a96a9ec03</cites><orcidid>0000-0001-7756-2704 ; 0000-0001-6647-6325</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-019-05822-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-019-05822-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,28253,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31493041$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ham, Nam Seok</creatorcontrib><creatorcontrib>Kim, Jeongseok</creatorcontrib><creatorcontrib>Oh, Eun Hye</creatorcontrib><creatorcontrib>Hwang, Sung Wook</creatorcontrib><creatorcontrib>Park, Sang Hyoung</creatorcontrib><creatorcontrib>Yang, Dong-Hoon</creatorcontrib><creatorcontrib>Ye, Byong Duk</creatorcontrib><creatorcontrib>Myung, Seung-Jae</creatorcontrib><creatorcontrib>Yang, Suk-Kyun</creatorcontrib><creatorcontrib>Byeon, Jeong-Sik</creatorcontrib><title>Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>DIGEST DIS SCI</addtitle><addtitle>Dig Dis Sci</addtitle><description>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.</description><subject>Biochemistry</subject><subject>Cancer</subject><subject>Clinical outcomes</subject><subject>Colorectal cancer</subject><subject>Comparative analysis</subject><subject>Cost analysis</subject><subject>Economic aspects</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gastroenterology & Hepatology</subject><subject>Hepatology</subject><subject>Life Sciences & Biomedicine</subject><subject>Medical colleges</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Transplant Surgery</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqN0VFr1TAYBuAgijtO_4AXUvBGkM4vaZI2l6NuKkwUHd6GNPm6ZbTNMWkR__3SnbM5RURykRCeN3ztS8hzCkcUoH6TKEgGJVBVgmgYK-EB2VBRVyUTsnlINkBlPlMqD8iTlK4AQNVUPiYHFeWqAk435LINaS5CX5xMLiQbtt4WX5duXGxIZije-pTQzj5MxTeMaUn33WePFkfM7OOef8Fb7adivsSiDUOI-WoZn5JHvRkSPtvvh-T89OS8fV-efXr3oT0-Ky3nbC47bpxgTcOhNr0TTddDV0kmnRPO8mwo611nrRSMmQYsMKidrY2SRqGF6pC82j27jeH7gmnWo08Wh8FMGJakGWukYkBFk-nLP-hVWOKUh1uV4LSq-D11YQbUfurDHI1dH9XHNWWq4vWNOvqLysvh6G2YsPf5_rcA2wVsDClF7PU2-tHEn5qCXtvVu3Z1blfftKvXj3uxnzg3hO4ucltnBs0O_MAu9Ml6nCzesdy_oIpzpfKJstbPZu2qDcs05-jr_49mXe10ymK6wPjr3_1j_mtr1s85</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Ham, Nam Seok</creator><creator>Kim, Jeongseok</creator><creator>Oh, Eun Hye</creator><creator>Hwang, Sung Wook</creator><creator>Park, Sang Hyoung</creator><creator>Yang, Dong-Hoon</creator><creator>Ye, Byong Duk</creator><creator>Myung, Seung-Jae</creator><creator>Yang, Suk-Kyun</creator><creator>Byeon, Jeong-Sik</creator><general>Springer US</general><general>Springer Nature</general><general>Springer</general><general>Springer Nature B.V</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7756-2704</orcidid><orcidid>https://orcid.org/0000-0001-6647-6325</orcidid></search><sort><creationdate>20200401</creationdate><title>Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum</title><author>Ham, Nam Seok ; Kim, Jeongseok ; Oh, Eun Hye ; Hwang, Sung Wook ; Park, Sang Hyoung ; Yang, Dong-Hoon ; Ye, Byong Duk ; Myung, Seung-Jae ; Yang, Suk-Kyun ; Byeon, Jeong-Sik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-b4ad5288407afd58bf0b3626dd5dc4c4412fdbcc6522a80c0207dc7a96a9ec03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Biochemistry</topic><topic>Cancer</topic><topic>Clinical outcomes</topic><topic>Colorectal cancer</topic><topic>Comparative analysis</topic><topic>Cost analysis</topic><topic>Economic aspects</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gastroenterology & Hepatology</topic><topic>Hepatology</topic><topic>Life Sciences & Biomedicine</topic><topic>Medical colleges</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Oncology, Experimental</topic><topic>Original Article</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Transplant Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ham, Nam Seok</creatorcontrib><creatorcontrib>Kim, Jeongseok</creatorcontrib><creatorcontrib>Oh, Eun Hye</creatorcontrib><creatorcontrib>Hwang, Sung Wook</creatorcontrib><creatorcontrib>Park, Sang Hyoung</creatorcontrib><creatorcontrib>Yang, Dong-Hoon</creatorcontrib><creatorcontrib>Ye, Byong Duk</creatorcontrib><creatorcontrib>Myung, Seung-Jae</creatorcontrib><creatorcontrib>Yang, Suk-Kyun</creatorcontrib><creatorcontrib>Byeon, Jeong-Sik</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ham, Nam Seok</au><au>Kim, Jeongseok</au><au>Oh, Eun Hye</au><au>Hwang, Sung Wook</au><au>Park, Sang Hyoung</au><au>Yang, Dong-Hoon</au><au>Ye, Byong Duk</au><au>Myung, Seung-Jae</au><au>Yang, Suk-Kyun</au><au>Byeon, Jeong-Sik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><stitle>DIGEST DIS SCI</stitle><addtitle>Dig Dis Sci</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>65</volume><issue>4</issue><spage>969</spage><epage>977</epage><pages>969-977</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31493041</pmid><doi>10.1007/s10620-019-05822-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7756-2704</orcidid><orcidid>https://orcid.org/0000-0001-6647-6325</orcidid></addata></record> |
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| source | Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; SpringerLink Journals - AutoHoldings |
| subjects | Biochemistry Cancer Clinical outcomes Colorectal cancer Comparative analysis Cost analysis Economic aspects Endoscopy Gastroenterology Gastroenterology & Hepatology Hepatology Life Sciences & Biomedicine Medical colleges Medicine Medicine & Public Health Oncology Oncology, Experimental Original Article Science & Technology Surgery Transplant Surgery |
| title | Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum |
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