Clinical outcomes and direct costings of endoluminal clipping compared to surgery in the management of iatrogenic colonic perforation. Issue 12 (5th November 2013)

• Record Type: Journal Article
• Authors: Chan, Wah‐Kheong; Roslani, April Camilla; Law, Chee‐Wei; Goh, Khean‐Lee; Mahadeva, Sanjiv
• Is Part Of: Journal of digestive diseases. Volume 14:Issue 12(2013:Dec.)
• Page Start: 670
• Page End: 675
• Publication Date: 2013-11-05
• Subjects: colonoscopy -- colorectal surgery -- direct costing -- endoscopic clipping -- perforation; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; 616.3
• DOI: 10.1111/1751-2980.12097
• Languages: English
• ISSNs: 1751-2972

Abstract

Abstract : Objective: To compare the outcomes and costs of endoluminal clipping and surgery in the management of iatrogenic colonic perforation. Methods: A retrospective, single‐center, clinical and economic analysis of outcomes and costings between endoluminal clipping and surgery in consecutive cases of iatrogenic colonic perforations was conducted. Results: In total, 7136 colonoscopies performed over a 6‐year period were complicated by 12 (0.17%) perforations. Seven cases were treated by endoscopic clipping (with a success rate of 71.4%) and five with immediate surgery. Both groups of patients had similar clinical and individual characteristics. Patients who were treated with endoscopic clipping had a shorter period of hospitalization (median 9 vs 13 days) compared to surgery, but this was not statistically significant. Compared to patients who had immediate surgery, the median direct health‐care costs for all procedures (US$ 115.10 vs US$ 1479.50, P = 0.012) and investigations (US$ 124.60 vs US$ 512.90, P = 0.048) during inpatient stay were lower for the endoscopic clipping group. There was a trend towards a lower overall inpatient median cost for patients managed with endoscopic clipping compared to surgery (US$ 1481.70 vs US$ 3281.90, P = 0.073). Conclusion: Endoluminal clipping may be more cost‐effective than surgery in the management of iatrogenic colonic perforations.