scholarly journals Cost Analysis of Endoscopic Submucosal Dissection for the Treatment of Colorectal Lesions in China

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Ning Cui ◽  
Yu Zhao ◽  
Honggang Yu
Keyword(s):  
Colorectal Cancer ◽  
Cost Analysis ◽  
Endoscopic Submucosal Dissection ◽  
Transverse Colon ◽  
Surgical Margin ◽  
Positive Surgical Margin ◽  
Labor Costs ◽  
Positive Surgical Margins ◽  
Submucosal Dissection ◽  
Treatment Medication

Aim. The aim of the study was to evaluate costs associated with colonic endoscopic submucosal dissection (ESD) for treatment of colorectal cancer. Methods. The study is a retrospective analysis of data on 395 patients treated by colonic ESD. Results. The operation, consumable items, and medication accounted for 71% of the total costs for colonic ESD treatment. Medication and consumable items’ costs were higher if lesions occurred in the transverse colon and right hemicolon compared to the left hemicolon. Medication, consumable items, and total costs were higher for larger lesions. Lesion numbers and carcinoma were associated with higher medication, consumable items, operation, and total costs. Positive surgical margins and complications of hemorrhage or perforation were positively correlated with higher costs for medication, consumable items, and total costs. Conclusion. Labor costs for doctors and nurses remain low in China. Costs for medication and consumable items were higher for treatment involving the transverse colon or right hemicolon (vs. the left hemicolon), larger lesions, carcinoma, and a positive surgical margin. A benchmark cost estimate for ESD treatment including 4 days of postoperative hospitalization was determined to be approximately 5400 USD.

General epidemiologic colorectal cancer profile in Oncologos del Occidente from Colombia, South America.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14693-e14693
Author(s):  
Tomas Sanchez Villegas ◽  
Carlos Raul Villegas Mejia ◽  
Jose Arnoby Chacon Cardona
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Clinical Stage ◽  
Surgical Margin ◽  
Partial Report ◽  
Cancer Center ◽  
Positive Surgical Margin ◽  
Final Report ◽  
Preoperative Treatment

e14693 Background: The Colorectal Cancer is one of the most common cancer in the US and the fourth cancer for the developing countries like in our area. Methods: This is a preliminary and partial report of a retrospective analysis from our cancer records in Oncologos del Occidente a Private Oncologic Cancer Center from Colombia. Results: 663 patients (50% of final report) from January 1997 to June 2012 with Colon Cancer 306(46%), Rectal Cancer 309(47%) y Anal Cancer (7%); 51% female; median age 60(range 16-92. sd:13.929); Urban Area 91%. Clinical stage I (7%), IIA (19%), IIB (3%), IIIA (5%), IIIB (13%) and IIIC (10%), IV (11%), Adenocarcinoma 81%, Mucinous (8%); Well differentiated (63%), Poorly differentiated (7%); pretreatment Carcino-embryonic antigen mean 32.778 ng/ml (range 0.18-550.0), Adverse prognostic factors were Obstruction (39%), Ulceration (31%), Lymph Vascular Invasion (10%), T4 Stage (5%), Perforation (4%), Positive Surgical Margin (2%) with two factors 21% and three factors 7%; Low rectal cancer was 90%, Non-Surgical treatment was Chemotherapy (CT) (37%), CT/Radiotherapy (RT) (35%), CT and RT (8%), RT (3%), None (16%); preoperative treatment 37%, First line CT was based on 5FU/LV (52%); 20% relapsed and the main recurrence pattern was Local-marginal (25%), Liver (17%), Pelvic peritoneal (3%), Carcinomatosis (8%) and Lung (23); Rescue treatment was CT (10%), Surgery+CT (1%), CT+RT (1%) and Surgery (1%); the main rescue CT was Folfox 2%, 5FU/LV (3%), Capecitabine (3%), Mixed 6%; Surgical Lymph nodes mean excised was 10.037 (0-38 SD.7.554) and positive nodes mean was 1.972(0-29 SD 3.503); Overall Survival at 5 years for Colon cancer is 63% and 53% to 10 years and Rectal cancer to 5 and 10 years is 45% and 36% respectively (p=0.001). Conclusions: These results reflect the colorectal cancer behavior in a specific area of Colombia and the importance of a multidisciplinary work.

P.12.9: Cost Analysis and Outcome of Endoscopic Submucosal Dissection for Colorectal Lesions in Outpatients Versus Inpatients

2017 ◽  
Vol 49 ◽  
pp. e214-e215
Author(s):  
R. Maselli ◽  
P.A. Galtieri ◽  
A. Fugazza ◽  
G. Lollo ◽  
L. Poliani ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Endoscopic Submucosal Dissection ◽  
Submucosal Dissection

scholarly journals SYSTEMATIC REVIEW AND METAANALYSIS OF TRANSANAL ENDOSCOPIC MICROSURGERY VERSUS ENDOSCOPIC SUBMUCOSAL DISSECTION FOR RECTAL ADENOMAS AND EARLY RECTAL CANCER

2019 ◽  
Vol 18 (2) ◽  
pp. 7-20
Author(s):  
S. V. Chernyshov ◽  
M. A. Tarasov ◽  
M. A. Nagudov ◽  
D. A. Mtvralashvili ◽  
A. Likutov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Rectal Cancer ◽  
Endoscopic Submucosal Dissection ◽  
Transanal Endoscopic Microsurgery ◽  
Meta Analysis ◽  
Early Colorectal Cancer ◽  
Early Rectal Cancer ◽  
Submucosal Dissection ◽  
Endoscopic Microsurgery

AIM: transanal endomicrosurgery (TEM) is the standard for organ-preserving treatment of patients with large adenomas and early rectal cancer. The advantage of TEM in comparison with other transanal methods of treatment of rectal tumors is the low frequency of R1 resections and fragmentation, which procudes a low level of local recurrences. Endoscopic submucosal dissection (ESD) is a new technology for superficial rectum tumors. This systematic review and meta-analysis compared safety and efficacy of ESD vs TEM for large adenoma and early colorectal cancer.PATIENTS AND METHODS: a literature search and meta-analysis of the data was carried out in accordance with the English-language Medline database without restrictions on the publication date (end December 18, 2018) according to keywords: «endoscopic submucosal dissection», «esd», «endoscopic dissection», «tem», «tamis», «transanal endoscopic microsurgery», «transanal resection», «teo», «transanal endoscopic microsurgical excision». The systematic review includes all papers on the comparison of TEM and ESD for large adenomas and early rectal cancer. Statistical data processing was performed using Review Manager 5.3.RESULTS: four retrospective comparative studies were included in the analysis (215 patients). Groups were homogenous in the number of tumors (Odds ratio [OR]=1,19; 95% confidence interval [CI] 0.23-6.16) and size (p=0.55). The intraoperative morbidity included bleeding (p=0.54) and rectal perforation (p=0.32) was homogenous as well. The operation time in the ESD group was significantly longer by 32 minutes than TEM (OR=32.5;95% CI 17,7-47.4; p<0.0001). Postoperative stay was higher than in 1.6 times after TEM (OR=16.1; 95% CI 1.5-30.1; p=0.03). The antibiotics use after surgery was not significantly different in both groups (p=0.33). The en-bloc resections (p=0.66) and the rate of R1 resections (p=0.74) were not significantly different in both groups. The local recurrence rate was homogenous (p=0.95).CONCLUSIONS: the ESD and TEM procedures are safe and effective techniques for local excision of adenomas and early colorectal cancer, but a randomized study is needed to prove the results.

The Margins

1996 ◽  
Vol 63 (2) ◽  
pp. 192-195
Author(s):  
P. Graziotti ◽  
A. Losa ◽  
D. Belussi ◽  
D. Chinaglia ◽  
A. Lembo
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Gradual Increase ◽  
Preoperative Staging ◽  
Surgical Margin ◽  
Seminal Vesicles ◽  
Positive Surgical Margin ◽  
Positive Surgical Margins ◽  
Positive Lymph Nodes

The gradual increase in indications for radical prostatectomy over these last few years has focussed attention on the issue of surgical margin positivity. In terms of prognosis, a positive surgical margin is comparable to lymph node positivity. The routine adoption of the most advanced anatomo-histological methods has increased our 17.5% of positive surgical margins to 30.2% despite surgical indication having become increasingly more rigid. In addition, more precise preoperative staging by echo-guided biopsy of the seminal vesicles and of periprostatic spaces, has allowed patients with positive lymph nodes to be reduced to just over 1%.

Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting

2019 ◽  
Vol 51 (3) ◽  
pp. 391-396
Author(s):  
Roberta Maselli ◽  
Piera Alessia Galtieri ◽  
Milena Di Leo ◽  
Elisa Chiara Ferrara ◽  
Andrea Anderloni ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Endoscopic Submucosal Dissection ◽  
Outpatient Setting ◽  
Submucosal Dissection
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