Medical аnd еconomic аspects оf the use of vacuum therapy for esophageal injures

Cover Page

Cite item

Full Text

Abstract

Background. Currently, endoscopic vacuum therapy (EVT) with an efficiency of up to 90% or more is actively used in the treatment of esophageal injuries. At the same time, the economic assessment of the advantages of minimally invasive methods has not been studied enough.

Aim. To Analysis of the economic component of EVT for esophageal injuries in comparison with classical interventions (thoracotomy, esophageal extirpation) in a regional multidisciplinary hospital.

Materials and methods. The analysis of the economic component of EVT in comparison with classical interventions was carried out by retrospectively examining the medical records of 43 patients. The cost of treatment in the comparison groups was estimated by including the cost of the patient's stay in the hospital and the direct costs of intervention.

Results. The conducted statistical analysis showed significant differences in the groups with a strong dependence of the cost of treatment on the patient's stay in the intensive care units and the direct costs of open surgery.

Conclusion. The use of minimally invasive and modern EVT methods for esophageal injuries can significantly shorten the patient's hospital stay. Compared to traditional surgical approaches, this approach allows for a reduction in the financial aspect by more than two times.

About the authors

Damir A. Demaldinov

Astrakhan State Medical University

Author for correspondence.
Email: demdamir@yandex.ru

Cand. Sci. (Med.), Assistant

Russian Federation, Astrakhan

Robert D. Mustafin

Astrakhan State Medical University

Email: robert.mustafin1@gmail.com

D. Sci. (Med.), Prof.

Russian Federation, Astrakhan

References

  1. Eichelmann AK, Ismail S, Merten J, et al. Economic Burden of Endoscopic Vacuum Therapy Compared to Alternative Therapy Methods in Patients with Anastomotic Leakage After Esophagectomy. J Gastrointest Surg. 2021;25(10):2447-54. doi: 10.1007/s11605-021-04955-w
  2. Knowlton LM, Minei J, Tennakoon L, et al. The economic footprint of acute care surgery in the United States: Implications for systems development. J Trauma Acute Care Surg. 2019;86(4):609-16. doi: 10.1097/TA.0000000000002181
  3. Chen J, Zhang W, Yang D. Meta-Resolve of Risk Factors for Nosocomial Infection in Patients Undergoing Thoracic Surgery. Contrast Media Mol Imaging. 2022;2022:2836014. doi: 10.1155/2022/2836014
  4. Mureșan M, Mureșan S, Balmoș I, et al. Sepsis in Acute Mediastinitis – A Severe Complication after Oesophageal Perforations. A Review of the Literature. J Crit Care Med (Targu Mures). 2019;5(2):49-55. doi: 10.2478/jccm-2019-0008
  5. Agzarian J, Visscher SL, Knight AW, et al. The cost burden of clinically significant esophageal anastomotic leaks-a steep price to pay. J Thorac Cardiovasc Surg. 2019;157(5):2086-92. doi: 10.1016/j.jtcvs.2018.10.137
  6. Browning AF, Chong L, Read M, et al. Economic burden of complications and readmission following oesophageal cancer surgery. ANZ J Surg. 2022;92(11):2901-6. doi: 10.1111/ans.18062
  7. Mennigen R, Harting C, Lindner K, et al. Comparison of Endoscopic Vacuum Therapy Versus Stent for Anastomotic Leak After Esophagectomy. J Gastrointest Surg. 2015;19(7):1229-35. doi: 10.1007/s11605-015-2847-7
  8. Jung CFM, Müller-Dornieden A, Gaedcke J, et al. Impact of Endoscopic Vacuum Therapy with Low Negative Pressure for Esophageal Perforations and Postoperative Anastomotic Esophageal Leaks. Digestion. 2021;102(3):469-79. doi: 10.1159/000506101
  9. Tavares G, Tustumi F, Tristão LS, et al. Endoscopic vacuum therapy for anastomotic leak in esophagectomy and total gastrectomy: a systematic review and meta-analysis. Dis Esophagus. 2021;34(5):doaa132. doi: 10.1093/dote/doaa132. Erratum in: Dis Esophagus. 2021;34(5).
  10. Baltin C, Kron F, Urbanski A, et al. The economic burden of endoscopic treatment for anastomotic leaks following oncological Ivor Lewis esophagectomy. PLoS One. 2019;14(8):e0221406. doi: 10.1371/journal.pone.0221406
  11. Ward MA, Hassan T, Burdick JS, et al. Endoscopic vacuum assisted wound closure (EVAC) device to treat esophageal and gastric leaks: assessing time to proficiency and cost. Surg Endosc. 2019;33(12):3970-5. doi: 10.1007/s00464-019-06685-2

Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. Mann-Whitney U-test data when comparing the total cost of inpatient care in the comparison groups

Download (72KB)

Copyright (c) 2024 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).