An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae.

Details

Serval ID
serval:BIB_538863302BC3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae.
Journal
Colorectal Disease
Author(s)
Fisher O.M., Raptis D.A., Vetter D., Novak A., Dindo D., Hahnloser D., Clavien P.A., Nocito A.
ISSN
1463-1318 (Electronic)
ISSN-L
1462-8910
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
17
Number
7
Pages
619-626
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
AIM: The study aimed to compare the rate of success and cost of anal fistula plug (AFP) insertion and endorectal advancement flap (ERAF) for anal fistula.
METHOD: Patients receiving an AFP or ERAF for a complex single fistula tract, defined as involving more than a third of the longitudinal length of of the anal sphincter, were registered in a prospective database. A regression analysis was performed of factors predicting recurrence and contributing to cost.
RESULTS: Seventy-one patients (AFP 31, ERAF 40) were analysed. Twelve (39%) recurrences occurred in the AFP and 17 (43%) in the ERAF group (P = 1.00). The median length of stay was 1.23 and 2.0 days (P < 0.001), respectively, and the mean cost of treatment was euro5439 ± euro2629 and euro7957 ± euro5905 (P = 0.021), respectively. On multivariable analysis, postoperative complications, underlying inflammatory bowel disease and fistula recurring after previous treatment were independent predictors of de novo recurrence. It also showed that length of hospital stay ≤ 1 day to be the most significant independent contributor to lower cost (P = 0.023).
CONCLUSION: Anal fistula plug and ERAF were equally effective in treating fistula-in-ano, but AFP has a mean cost saving of euro2518 per procedure compared with ERAF. The higher cost for ERAF is due to a longer median length of stay.
Keywords
Adult, Costs and Cost Analysis, Databases, Factual, Female, Humans, Length of Stay, Male, Middle Aged, Proctoscopy/economics, Proctoscopy/instrumentation, Prospective Studies, Rectal Fistula/economics, Rectal Fistula/pathology, Rectum/surgery, Recurrence, Retrospective Studies, Surgical Flaps/economics, Surgical Instruments/economics, Treatment Outcome
Pubmed
Web of science
Create date
20/07/2015 9:54
Last modification date
20/08/2019 14:08
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