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Outcome and Cost Analysis of Hand-Sewn and Stapled Anastomoses in the Reversal of Loop Ileostomy
Journal article   Peer reviewed

Outcome and Cost Analysis of Hand-Sewn and Stapled Anastomoses in the Reversal of Loop Ileostomy

Zoltan H Nemeth, Dorian A Bogdanovski, Addison S Hicks, Samantha R Paglinco, Rohan Sawhney, Stefanie A Pilip, Patricia B Stopper and Rolando H Rolandelli
The American surgeon, v 84(5), pp 615-619
01 May 2018
DOI: https://doi.org/10.1177/000313481808400509
PMID: 29966558
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1177/000313481808400509View
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Abstract

Adult Anastomosis, Surgical - economics Anastomosis, Surgical - methods Female Hospital Charges - statistics & numerical data Hospital Costs - statistics & numerical data Humans Ileostomy - economics Ileostomy - methods Male Middle Aged New Jersey Reoperation - economics Retrospective Studies Surgical Stapling - economics Suture Techniques - economics
Diverting loop ileostomies are common procedures for protecting high-risk anastomoses. There is little consensus on the most ideal technique both in terms of cost efficiency and outcome. Data for this study were collected from 101 patients who underwent loop ileostomy reversal between 2009 and 2014 at Morristown Medical Center. Of the 101 patients included in the review, 57 received a hand-sewn anastomosis (HS-A) and 44 received a stapled anastomosis (S-A). Average total hospital charges for stapled anastomoses were significantly greater than that for hand-sewn anastomoses, as were total operating room supply costs. When the total cost of the operation itself was considered, S-A cases were still found to be significantly greater than HS-A cases. Hospital room charges, total lab charges, pathology charges, and EKG/ECG charges were all greater for S-A cases than HS-A cases. Overall costs were greater for S-As than hand-sewn anastomoses and because of a lack of difference in procedure length, stapler supply costs were not offset. Complication rates and length of stay were also similar between the techniques. We found S-A cases to be more costly and have a greater cost/hour than HS-A cases.

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Surgery
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