Titre
An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Fisher, O.M.
Auteure/Auteur
Raptis, D.A.
Auteure/Auteur
Vetter, D.
Auteure/Auteur
Novak, A.
Auteure/Auteur
Dindo, D.
Auteure/Auteur
Hahnloser, D.
Auteure/Auteur
Clavien, P.A.
Auteure/Auteur
Nocito, A.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1463-1318
Statut éditorial
Publié
Date de publication
2015
Volume
17
Numéro
7
Première page
619
Dernière page/numéro d’article
626
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
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.
Sujets
PID Serval
serval:BIB_538863302BC3
PMID
Open Access
Oui
Date de création
2015-07-20T08:54:01.258Z
Date de création dans IRIS
2025-05-20T13:45:56Z
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Nom
Colorectal Disease - 2015 - Fisher - An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement.pdf
Version du manuscrit
published
Taille
142.04 KB
Format
Adobe PDF
PID Serval
serval:BIB_538863302BC3.P001
URN
urn:nbn:ch:serval-BIB_538863302BC32
Somme de contrôle
(MD5):138b5b3a9a2f4e58d93f8a89047e15b8