Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 21 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Colonic stent vs emergency surgery for colonic obstruction

Colonic stent insertion followed by elective surgery appears more effective and less costly than emergency surgery under base-case conditions, reports the most recent issue of Gastrointestinal Endoscopy.

News image

fiogf49gjkf04

Acute colonic obstruction because of malignancy is often a surgical emergency.

Surgical decompression with colostomy with or without resection and eventual re-anastomosis is the traditional treatment of choice.

Endoscopic colonic stent insertion effectively decompresses the obstructed colon, allowing for surgery to be performed electively.

Dr Farrell and colleagues from Los Angeles in America undertook a study in order to determine the cost-effectiveness of colonic stent vs. surgery for emergent management of acute malignant colonic obstruction.

The researchers used decision analysis to calculate the cost-effectiveness of 2 competing strategies in a hypothetical patient presenting with acute, complete, malignant colonic obstruction.

The first strategy examined was using an emergent colonic stent followed by elective surgical resection and re-anastomosis.

Colonic stent procedure resulted in 23% fewer operative procedures per patient
Gastrointestinal Endoscopy

The researchers copmpared the outcomes of this technique with the outcomes of emergent surgical resection followed by diversion (Hartmann's procedure) or primary anastomosis.

The research team obtained cost estimates from a third-party payer perspective.

Primary outcome measures were mortality, stoma requirement, and total number of operative procedures.

The researchers found that colonic stent procedure resulted in 23% fewer operative procedures per patient, an 83% reduction in stoma requirement, and lower procedure-related mortality.

The research team noted that the colonic stent procedure was associated with a lower mean cost per patient ($45,709 vs. $49,941).

Dr Farrell concluded, "Colonic stent insertion followed by elective surgery appears more effective and less costly than emergency surgery under base-case conditions."

"This finding remains robust over a wide range of assumptions for clinical inputs in sensitivity analysis."

"Our findings suggest that colonic stent insertion should be offered, whenever feasible, as a bridge to elective surgery in patients presenting with malignant colonic obstruction."

Gastrointestinal Endoscopy; 2004: 60 (6): 865
22 December 2004

Go to top of page Email this page Email this page to a colleague

 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 11 May 2018 
Depressive symptoms in IBD youth
 10 May 2018 
Post‐operative complications in elderly IBD
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
PPI use and cognitive decline
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 30 April 2018 
Patient-reported outcome measures in IBD trials
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Fecal incontinence and quality of life in IBD
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's
 24 April 2018 
Microbiome in athletes vs sedentary subjects
 24 April 2018 
PPI and risk of stroke
 23 April 2018 
Genome-wide study on HBV-related acute-on-chronic liver failure
 23 April 2018 
Antibody suitable for further clinical development to complement existing therapeutic strategies for HCV
 23 April 2018 
Sleep deprivation and NAFLD in the USA
 20 April 2018 
Two annexin A11 epitopes targeted by IgG1 and IgG4 autoantibodies were shared between patients with IAC/AIP and IgG4 antibodies blocked binding of IgG1 antibodies to the shared annexin A11 epitopes
 20 April 2018 
Adalimumab with azathioprine in Crohn's
 20 April 2018 
Worldwide H.pylori prevalence
 19 April 2018 
c-Myc expression and pancreatic cancer
 19 April 2018 
Olmesartan prescription in the USA

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us