A propensity-matched comparison of cost and outcomes after esophageal stent placement or primary surgical repair for iatrogenic esophageal perforation

The Journal of Thoracic and Cardiovascular Surgery
Richard K FreemanRaja S Mahidhara

Abstract

Esophageal stent placement has been shown to be a safe and effective treatment for acute esophageal perforation in selected patients. However, a comparison between surgical repair and stent placement has not been reported. This investigation compares the outcomes and costs of the 2 treatment modalities. The Premiere database for a single health system's hospitals was used to identify patients undergoing treatment for an acute intrathoracic esophageal perforation over a 4-year period. Patient cohorts for stent placement or surgical repair were formed using propensity matching. The 2 cohorts were compared for length of stay, morbidity, mortality, and costs. Between 2009 and 2012, 60 patients undergoing esophageal stent placement or surgical repair were propensity matched. Mean patient age and Charlson comorbidity scores did not differ significantly (P = .4 and P = .4, respectively). Significant differences in morbidity (4% vs 43%; P = .02), mean length of stay (6 vs 11 days; P = .0007), time to oral intake (3 vs 8 days; P = .0004), and cost ($91,000 vs $142,000; P < .0001) were identified in the esophageal stent cohort when compared with patients receiving surgical repair. Operative mortality did not differ significantly. Esophag...Continue Reading

References

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Citations

Mar 31, 2015·The Journal of Thoracic and Cardiovascular Surgery·Katie S Nason
Jan 25, 2017·Current Treatment Options in Gastroenterology·Payal Saxena, Mouen A Khashab
Sep 17, 2019·Intractable & Rare Diseases Research·Azka LatifJoseph M Stavas
Dec 11, 2019·Minerva gastroenterologica e dietologica·Carmelo LuigianoLeonardo H Eusebi
Oct 2, 2020·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Anoop JohnInian Samarasam
Jan 13, 2017·Surgical Endoscopy·Fausto BiancariJuha Saarnio
Sep 9, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J T AliK G Khalil
Oct 17, 2019·Minerva gastroenterologica e dietologica·Sharareh MoravejiAli Siddiqui
Jun 3, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·E Ilias K SdralisA Charalabopoulos
Jun 6, 2019·World Journal of Emergency Surgery : WJES·Mircea ChiricaLuigi Bonavina
Sep 9, 2017·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·S PerssonL Lundell
Jul 3, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Andrea L AxtellCameron D Wright
Feb 26, 2021·Annals of Surgery·Andrew TangSudish C Murthy

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