Randomized controlled trial of colonic stent insertion in non-curable large bowel obstruction: a post hoc cost analysis

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
C J Young, A Zahid

Abstract

In view of the increasing burden on the healthcare system, this study aims to perform a cost-effectiveness analysis of the management of incurable large bowel obstruction comparing the cost of a stent vs surgery. A prospective randomized controlled trial was conducted at two major teaching hospitals in Australia between September 2006 and November 2011. Fifty-six patients with malignant incurable large bowel obstruction were randomized to stent insertion or surgical decompression, of whom 52 were included in the final analysis. Data were collected at all points during the patient journey and quality of life data were obtained by patient surveys. All data points were analysed and a cost-effectiveness study was performed to compare the costs between the two treatment groups. Stenting as a procedure was significantly more expensive than surgery (A$4462.50 vs A$3251.50; P < 0.001). Post-procedure stay for stented patients was significantly lower (median 7 vs 11 days; P = 0.03). Combined costs of stent group ward stay, multidisciplinary team discussion and complication management were significantly lower (P = 0.013). Overall cost difference between the two treatment groups was A$3902.44 (P = 0.101). European Quality of Life - 5 Dime...Continue Reading

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