 |
|
Cost-effectiveness of Defunctioning Stomas in Low Anterior Resections for Rectal Cancer—Invited Critique
Richard J. Heald, MChir, FRCS
Basingstoke, England
Arch Surg. 2003;138:1339.
|
|
| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
|
|
|
Cost matters. Extra safety must be paid for. Koperna's article provides an excellent example. Protecting an LAR increases the cost of an anterior resection in Mistelbach, Austria, from US $10 000 to US $15 000. An unprotected leak requiring a Hartmann operation costs US $50 000. A clinician might add that it may cost the patient his or her life and is very likely to mean a permanent stoma—costing perhaps US $4000 per year thereafter.
Patients care little about initial cost: they want the lowest possible long-term outcome costs—0 for a cure with no stoma! I believe that outcome cost accounting would be even more valuable. In this article it is most interesting that the principal cost drivers after LAR are 1 initial cost (defunctioning) and 1 short-term outcome cost (leakage). However, most surgeons construct a defunction because they are afraid of the occasional death from leakage—this defies . . . [Full Text of this Article]
RELATED ARTICLE
Cost-effectiveness of Defunctioning Stomas in Low Anterior Resections for Rectal Cancer: A Call for Benchmarking
Thomas Koperna
Arch Surg. 2003;138(12):1334-1338.
ABSTRACT
| FULL TEXT
|
