Cost-effectiveness Comparison of Manual Layered Anastomosis with Mechanical Stapling Technique in Esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHENGFeng-zhang , XUEJi-jun , ZHAOHai-long , ZHUXiao-kang ,  ZHUZi-jiang

Department of Thoracic Surgery, Gansu Tumor Hospital, Lanzhou 730050, P. R. China;

Corresponding?author：

ZHUZi-jiang, Email: zhuzijiang2005@sina.com

Keywords：

Esophageal carcinoma; Manual layered anastomosis; Mechanical stapling technique; Cost-effectiveness analysis

DOI：

10.7507/1007-4848.20140142

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare medical cost and utilization efficiency of medical resources between manual layered anastomosis with mechanical stapling technique in esophagectomy. Methods Clinical data of 132 patients who underwent surgical resection of esophageal carcinoma in the Department of Thoracic Surgery of Gansu Tumor Hospital between January and October 2011 were respectively analyzed. According to different anastomotic techniques, all the patients were divided into a manual layered anastomosis group (including 40 males and 20 females with their age of 36-72 (49.3±7.6) years) and a mechanical stapling technique group (including 50 males and 22 females with their age of 30-79 (51.0±8.6) years). Demographic data, operation data, postoperative complications, direct and indirect medical cost, and constitution of direct medical cost were compared between the 2 groups. Results Medical cost of esophagectomy was 14 505.03± 1 523.37 yuan in the manual layered anastomosis group and 19 891.05±1 634.58 yuan in the mechanical stapling technique group respectively, which were statistically different (P < 0.05). Material cost was 2 242.00±751.08 yuan in the manual layered anastomosis group and 5 424.00±1 876.22 yuan in the mechanical stapling technique group respectively, which were statistically different (P < 0.05). Cost-effectiveness analysis showed that cost-effectiveness ratio in the manual layered anastomosis group was lower, thus this anastomotic technique was more reasonable. Conclusion Medical cost of manual layered anastomosis is lower than that of mechanical stapling technique in esophagectomy, as the utilization efficiency of medical resources of manual layered anastomosis is higher than that of mechanical stapling technique.

Citation： ZHENGFeng-zhang, XUEJi-jun, ZHAOHai-long, ZHUXiao-kang, ZHUZi-jiang. Cost-effectiveness Comparison of Manual Layered Anastomosis with Mechanical Stapling Technique in Esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(4): 503-506. doi: 10.7507/1007-4848.20140142 Copy

1.	Shimada H, Shiratori T, Okazumi S, et al. Have surgical outcomes of pathologic T4 esophageal squamous cell carcinoma really improved? Analysis of 268 cases during 45years of experience. J Am Coll Surg, 2008, 206 (1):48-56.
2.	Zhu ZJ, Zhao YF, Chen LQ, et al. Clinical application of layered anastomosis in esophagogastrostomy. World J Surg, 2008, 32 (4):583-588.
3.	王文憑, 陳龍奇.食管癌外科治療新進展.中華臨床醫師雜志:電子版, 2009, 3 (11):1797-1803.
4.	鄭鴻, 程永德, 李勇, 等.中晚期原發性肺癌介入治療療效和經濟學分析.中國腫瘤, 2005, 14 (7):443-445.
5.	Janson M, Bjorhoh I, Carlsson P, et al. Randomized clinical trial of the costs of open and laparoscopic surgery forcolonic cancer.Br J Surg, 2004, 91 (4):409-417.
6.	Hartley JE, Mehigan BJ, Qureshi AE, et al. Total mesorectal excision:assessment of the laparoscopic approach. Dis Colon Rectum, 2001, 44 (3):315-321.
7.	Pikarsky AJ, Rosenthal R, Weiss EG, et al. Laparoscopictotal mesorectal excision.Surg Endosc, 2002, l6 (4):558-562.
8.	鐘釧, 譚家駒, 徐致祥.食管癌流行病學病因學研究進展.河南預防醫學, 2011, 22 (1):1-17.
9.	赫捷, 邵康.中國食管癌流行病學現狀、診療現狀及未來對策.中國癌癥雜志, 2011, 21 (7):501-504.
10.	Martin LW, Hofstetter W, Swisher SG, et al. Management of intra thoracic leaks following esophag ectomy. Adv Surg, 2006, 40:173-190.
11.	史加海, 劉俊華.食管癌手術手工吻合與管狀吻合器吻合的療效比較.世界腫瘤雜志, 2005, 4 (3):196-197.
12.	蔡瑞君, 李梅, 熊剛, 等.機械吻合和手工吻合兩種食管癌切除術的比較.南方醫科大學學報, 2012, 32 (6):908-912.
13.	翁偉建, 司建榮, 雷道鑫, 等.吻合器機械吻合與手工吻合在食管賁門癌術后并發癥的對比研究.局解手術學雜志, 2006, 15 (2):76-77.
14.	蘇紅凱, 周成運, 趙鵬, 等.食管癌切除頸部改良單層吻合術.中華胸心血管外科雜志, 2004, 20 (3):154.
15.	貢力, 方良偉, 田小豐, 等.胃代食管左頸部套入式吻合術治療食管癌.實用臨床醫藥雜志, 2009, 13 (6):53-54.
16.	陳名久, 吳顯寧, 尹邦良, 等.可吸收線分層縫合法在頸部食管胃吻合術中的應用.中南大學學報:醫學版, 2011, 36 (3):273-277.
17.	趙雍凡, 解晨昊, 王允, 等.食管胃分層吻合法的應用與實驗觀察.中國胸心血管外科臨床雜志, 2005, 12 (3):164-168.
18.	任志, 李龍, 付茂勇.食管胃手工分層吻合術治療食管癌、食管胃交界部癌的療效觀察.川北醫學院學報, 2012, 27 (1):10-12.
19.	陳倫元, 任守陽, 王允, 等.食管胃手工分層吻合與機械吻合的成本效果分析.臨床和實驗醫學雜志, 2008, 7 (7):5-6.
20.	權大榮, 夏時蒼, 楊永太.食管胃分層吻合法與三葉鉗應用預防吻合口并發癥.四川醫學, 2004, 25 (1):28.
21.	姚陳溉, 姚健, 官禹, 等.三葉鉗分層吻合術在食管癌手術中的應用.四川醫學, 2006, 27 (1):282-283.

1. Shimada H, Shiratori T, Okazumi S, et al. Have surgical outcomes of pathologic T4 esophageal squamous cell carcinoma really improved? Analysis of 268 cases during 45years of experience. J Am Coll Surg, 2008, 206 (1):48-56.
2. Zhu ZJ, Zhao YF, Chen LQ, et al. Clinical application of layered anastomosis in esophagogastrostomy. World J Surg, 2008, 32 (4):583-588.
3. 王文憑, 陳龍奇.食管癌外科治療新進展.中華臨床醫師雜志:電子版, 2009, 3 (11):1797-1803.
4. 鄭鴻, 程永德, 李勇, 等.中晚期原發性肺癌介入治療療效和經濟學分析.中國腫瘤, 2005, 14 (7):443-445.
5. Janson M, Bjorhoh I, Carlsson P, et al. Randomized clinical trial of the costs of open and laparoscopic surgery forcolonic cancer.Br J Surg, 2004, 91 (4):409-417.
6. Hartley JE, Mehigan BJ, Qureshi AE, et al. Total mesorectal excision:assessment of the laparoscopic approach. Dis Colon Rectum, 2001, 44 (3):315-321.
7. Pikarsky AJ, Rosenthal R, Weiss EG, et al. Laparoscopictotal mesorectal excision.Surg Endosc, 2002, l6 (4):558-562.
8. 鐘釧, 譚家駒, 徐致祥.食管癌流行病學病因學研究進展.河南預防醫學, 2011, 22 (1):1-17.
9. 赫捷, 邵康.中國食管癌流行病學現狀、診療現狀及未來對策.中國癌癥雜志, 2011, 21 (7):501-504.
10. Martin LW, Hofstetter W, Swisher SG, et al. Management of intra thoracic leaks following esophag ectomy. Adv Surg, 2006, 40:173-190.
11. 史加海, 劉俊華.食管癌手術手工吻合與管狀吻合器吻合的療效比較.世界腫瘤雜志, 2005, 4 (3):196-197.
12. 蔡瑞君, 李梅, 熊剛, 等.機械吻合和手工吻合兩種食管癌切除術的比較.南方醫科大學學報, 2012, 32 (6):908-912.
13. 翁偉建, 司建榮, 雷道鑫, 等.吻合器機械吻合與手工吻合在食管賁門癌術后并發癥的對比研究.局解手術學雜志, 2006, 15 (2):76-77.
14. 蘇紅凱, 周成運, 趙鵬, 等.食管癌切除頸部改良單層吻合術.中華胸心血管外科雜志, 2004, 20 (3):154.
15. 貢力, 方良偉, 田小豐, 等.胃代食管左頸部套入式吻合術治療食管癌.實用臨床醫藥雜志, 2009, 13 (6):53-54.
16. 陳名久, 吳顯寧, 尹邦良, 等.可吸收線分層縫合法在頸部食管胃吻合術中的應用.中南大學學報:醫學版, 2011, 36 (3):273-277.
17. 趙雍凡, 解晨昊, 王允, 等.食管胃分層吻合法的應用與實驗觀察.中國胸心血管外科臨床雜志, 2005, 12 (3):164-168.
18. 任志, 李龍, 付茂勇.食管胃手工分層吻合術治療食管癌、食管胃交界部癌的療效觀察.川北醫學院學報, 2012, 27 (1):10-12.
19. 陳倫元, 任守陽, 王允, 等.食管胃手工分層吻合與機械吻合的成本效果分析.臨床和實驗醫學雜志, 2008, 7 (7):5-6.
20. 權大榮, 夏時蒼, 楊永太.食管胃分層吻合法與三葉鉗應用預防吻合口并發癥.四川醫學, 2004, 25 (1):28.
21. 姚陳溉, 姚健, 官禹, 等.三葉鉗分層吻合術在食管癌手術中的應用.四川醫學, 2006, 27 (1):282-283.

Previous Article
Diagnosis and Treatment of Postoperative Hhypoparathyroidism
Next Article
Treatment Strategy of The Popliteal Artery Lesions

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Cost-effectiveness Comparison of Manual Layered Anastomosis with Mechanical Stapling Technique in Esophagectomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content