Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting
Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse event...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Maselli, Roberta [verfasserIn] Galtieri, Piera Alessia [verfasserIn] Di Leo, Milena [verfasserIn] Ferrara, Elisa Chiara [verfasserIn] Anderloni, Andrea [verfasserIn] Carrara, Silvia [verfasserIn] Vanni, Elena [verfasserIn] Mangiavillano, Benedetto [verfasserIn] Genco, Alfredo [verfasserIn] Al Awadhi, Sameer [verfasserIn] Fuccio, Lorenzo [verfasserIn] Hassan, Cesare [verfasserIn] Repici, Alessandro [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Digestive and liver disease - [S.l.] : Saunders, 2000, 51, Seite 391-396 |
|---|---|
| Übergeordnetes Werk: |
volume:51 ; pages:391-396 |
| DOI / URN: |
10.1016/j.dld.2018.09.023 |
|---|
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ELV001789821 |
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| 245 | 1 | 0 | |a Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting |
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| 520 | |a Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. | ||
| 650 | 4 | |a Colorectal ESD | |
| 650 | 4 | |a Endoscopic submucosal dissection | |
| 650 | 4 | |a ESD | |
| 650 | 4 | |a Outpatient ESD | |
| 700 | 1 | |a Galtieri, Piera Alessia |e verfasserin |4 aut | |
| 700 | 1 | |a Di Leo, Milena |e verfasserin |4 aut | |
| 700 | 1 | |a Ferrara, Elisa Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Anderloni, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Carrara, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Vanni, Elena |e verfasserin |0 (orcid)0000-0003-4928-3550 |4 aut | |
| 700 | 1 | |a Mangiavillano, Benedetto |e verfasserin |4 aut | |
| 700 | 1 | |a Genco, Alfredo |e verfasserin |4 aut | |
| 700 | 1 | |a Al Awadhi, Sameer |e verfasserin |4 aut | |
| 700 | 1 | |a Fuccio, Lorenzo |e verfasserin |0 (orcid)0000-0001-8618-2447 |4 aut | |
| 700 | 1 | |a Hassan, Cesare |e verfasserin |4 aut | |
| 700 | 1 | |a Repici, Alessandro |e verfasserin |4 aut | |
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10.1016/j.dld.2018.09.023 doi (DE-627)ELV001789821 (ELSEVIER)S1590-8658(18)30993-9 DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Maselli, Roberta verfasserin aut Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. Colorectal ESD Endoscopic submucosal dissection ESD Outpatient ESD Galtieri, Piera Alessia verfasserin aut Di Leo, Milena verfasserin aut Ferrara, Elisa Chiara verfasserin aut Anderloni, Andrea verfasserin aut Carrara, Silvia verfasserin aut Vanni, Elena verfasserin (orcid)0000-0003-4928-3550 aut Mangiavillano, Benedetto verfasserin aut Genco, Alfredo verfasserin aut Al Awadhi, Sameer verfasserin aut Fuccio, Lorenzo verfasserin (orcid)0000-0001-8618-2447 aut Hassan, Cesare verfasserin aut Repici, Alessandro verfasserin aut Enthalten in Digestive and liver disease [S.l.] : Saunders, 2000 51, Seite 391-396 Online-Ressource (DE-627)336455283 (DE-600)2061359-3 (DE-576)267762070 1878-3562 nnns volume:51 pages:391-396 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 51 391-396 |
| spelling |
10.1016/j.dld.2018.09.023 doi (DE-627)ELV001789821 (ELSEVIER)S1590-8658(18)30993-9 DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Maselli, Roberta verfasserin aut Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. Colorectal ESD Endoscopic submucosal dissection ESD Outpatient ESD Galtieri, Piera Alessia verfasserin aut Di Leo, Milena verfasserin aut Ferrara, Elisa Chiara verfasserin aut Anderloni, Andrea verfasserin aut Carrara, Silvia verfasserin aut Vanni, Elena verfasserin (orcid)0000-0003-4928-3550 aut Mangiavillano, Benedetto verfasserin aut Genco, Alfredo verfasserin aut Al Awadhi, Sameer verfasserin aut Fuccio, Lorenzo verfasserin (orcid)0000-0001-8618-2447 aut Hassan, Cesare verfasserin aut Repici, Alessandro verfasserin aut Enthalten in Digestive and liver disease [S.l.] : Saunders, 2000 51, Seite 391-396 Online-Ressource (DE-627)336455283 (DE-600)2061359-3 (DE-576)267762070 1878-3562 nnns volume:51 pages:391-396 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 51 391-396 |
| allfields_unstemmed |
10.1016/j.dld.2018.09.023 doi (DE-627)ELV001789821 (ELSEVIER)S1590-8658(18)30993-9 DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Maselli, Roberta verfasserin aut Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. Colorectal ESD Endoscopic submucosal dissection ESD Outpatient ESD Galtieri, Piera Alessia verfasserin aut Di Leo, Milena verfasserin aut Ferrara, Elisa Chiara verfasserin aut Anderloni, Andrea verfasserin aut Carrara, Silvia verfasserin aut Vanni, Elena verfasserin (orcid)0000-0003-4928-3550 aut Mangiavillano, Benedetto verfasserin aut Genco, Alfredo verfasserin aut Al Awadhi, Sameer verfasserin aut Fuccio, Lorenzo verfasserin (orcid)0000-0001-8618-2447 aut Hassan, Cesare verfasserin aut Repici, Alessandro verfasserin aut Enthalten in Digestive and liver disease [S.l.] : Saunders, 2000 51, Seite 391-396 Online-Ressource (DE-627)336455283 (DE-600)2061359-3 (DE-576)267762070 1878-3562 nnns volume:51 pages:391-396 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 51 391-396 |
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10.1016/j.dld.2018.09.023 doi (DE-627)ELV001789821 (ELSEVIER)S1590-8658(18)30993-9 DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Maselli, Roberta verfasserin aut Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. Colorectal ESD Endoscopic submucosal dissection ESD Outpatient ESD Galtieri, Piera Alessia verfasserin aut Di Leo, Milena verfasserin aut Ferrara, Elisa Chiara verfasserin aut Anderloni, Andrea verfasserin aut Carrara, Silvia verfasserin aut Vanni, Elena verfasserin (orcid)0000-0003-4928-3550 aut Mangiavillano, Benedetto verfasserin aut Genco, Alfredo verfasserin aut Al Awadhi, Sameer verfasserin aut Fuccio, Lorenzo verfasserin (orcid)0000-0001-8618-2447 aut Hassan, Cesare verfasserin aut Repici, Alessandro verfasserin aut Enthalten in Digestive and liver disease [S.l.] : Saunders, 2000 51, Seite 391-396 Online-Ressource (DE-627)336455283 (DE-600)2061359-3 (DE-576)267762070 1878-3562 nnns volume:51 pages:391-396 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 51 391-396 |
| allfieldsSound |
10.1016/j.dld.2018.09.023 doi (DE-627)ELV001789821 (ELSEVIER)S1590-8658(18)30993-9 DE-627 ger DE-627 rda eng 610 DE-600 44.87 bkl Maselli, Roberta verfasserin aut Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting 2018 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. Colorectal ESD Endoscopic submucosal dissection ESD Outpatient ESD Galtieri, Piera Alessia verfasserin aut Di Leo, Milena verfasserin aut Ferrara, Elisa Chiara verfasserin aut Anderloni, Andrea verfasserin aut Carrara, Silvia verfasserin aut Vanni, Elena verfasserin (orcid)0000-0003-4928-3550 aut Mangiavillano, Benedetto verfasserin aut Genco, Alfredo verfasserin aut Al Awadhi, Sameer verfasserin aut Fuccio, Lorenzo verfasserin (orcid)0000-0001-8618-2447 aut Hassan, Cesare verfasserin aut Repici, Alessandro verfasserin aut Enthalten in Digestive and liver disease [S.l.] : Saunders, 2000 51, Seite 391-396 Online-Ressource (DE-627)336455283 (DE-600)2061359-3 (DE-576)267762070 1878-3562 nnns volume:51 pages:391-396 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.87 Gastroenterologie AR 51 391-396 |
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Enthalten in Digestive and liver disease 51, Seite 391-396 volume:51 pages:391-396 |
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Maselli, Roberta @@aut@@ Galtieri, Piera Alessia @@aut@@ Di Leo, Milena @@aut@@ Ferrara, Elisa Chiara @@aut@@ Anderloni, Andrea @@aut@@ Carrara, Silvia @@aut@@ Vanni, Elena @@aut@@ Mangiavillano, Benedetto @@aut@@ Genco, Alfredo @@aut@@ Al Awadhi, Sameer @@aut@@ Fuccio, Lorenzo @@aut@@ Hassan, Cesare @@aut@@ Repici, Alessandro @@aut@@ |
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2018-01-01T00:00:00Z |
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Maselli, Roberta |
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610 DE-600 44.87 bkl Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting Colorectal ESD Endoscopic submucosal dissection ESD Outpatient ESD |
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Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting |
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Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting |
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Maselli, Roberta Galtieri, Piera Alessia Di Leo, Milena Ferrara, Elisa Chiara Anderloni, Andrea Carrara, Silvia Vanni, Elena Mangiavillano, Benedetto Genco, Alfredo Al Awadhi, Sameer Fuccio, Lorenzo Hassan, Cesare Repici, Alessandro |
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cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting |
| title_auth |
Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting |
| abstract |
Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. |
| abstractGer |
Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. |
| abstract_unstemmed |
Background and study aims: Endoscopic submucosal dissection (ESD), a minimally invasive treatment for early gastrointestinal (GI) cancer, is considered challenging and risky in the colorectum. As such, most patients undergoing ESD are hospitalized due to the perceived increased risk of adverse events. The aim of this study was to compare the costs, safety and efficacy of colorectal-ESD in an outpatient vs inpatient setting in a tertiary level center.Methods: This is a retrospective study on consecutive patients admitted for colorectal-ESD. Patients were divided into outpatients (Group-A, same-day discharge), and inpatients (Group-B, admitted for at least one night). Data on overall costs, outcomes and adverse events were assessed for each group.Results: A total of 136 patients were considered. Fourteen were excluded because ESD was not performed due to intraprocedural suspicion of invasive cancer. Eighty-three patients were treated as outpatients (Group-A, 68%) and 39 (Group-B, 32%) were hospitalized. R0-rate was 90.4% in Group-A and 89.7% in Group-B(P = 0.98). One perforation occurred in Group-A (1.2%) and 2 in Group-B(5.1%, P = 0.2). Mean Length of stay (LOS) was 1 day for outpatients and 3.3 days for inpatients. Management of Group-A as outpatients produced a cost savings of 941€ on average per patient.Conclusions: Outpatient colorectal-ESD is a feasible, cost-effective strategy to manage superficial colorectal tumors with outcomes comparable to inpatient colorectal-ESD. By using proper selection criteria, outpatient ESD could be considered the first-line approach for most patients. |
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Cost analysis and outcome of endoscopic submucosal dissection for colorectal lesions in an outpatient setting |
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Galtieri, Piera Alessia Di Leo, Milena Ferrara, Elisa Chiara Anderloni, Andrea Carrara, Silvia Vanni, Elena Mangiavillano, Benedetto Genco, Alfredo Al Awadhi, Sameer Fuccio, Lorenzo Hassan, Cesare Repici, Alessandro |
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