The economic impact of anastomotic leak after colorectal cancer surgery

• Published in: Health economics review 2023-02, Vol.13 (1), p.12-12, Article 12
• Main Authors: Flor-Lorente, Blas, Noguera-Aguilar, José Francisco, Delgado-Rivilla, Salvadora, García-González, José María, Rodriguez-Martín, Marcos, Salinas-Ortega, Laura, Casado, Miguel Ángel, Álvarez, María
• Format: Article
• Language: English
• Subjects: Anastomotic leak; Colorectal cancer; Cost; Economic impact; Health Care Management; Health Economics; Health Services Research; Medicine; Medicine & Public Health; Ostomy; Patients; Pharmacoeconomics and Health Outcomes; Public Finance; Public Health; Resection; Spain; Stoma; Surgical anastomosis
• ISSN: 2191-1991; 2191-1991
• DOI: 10.1186/s13561-023-00425-y

Objective To determine the economic impact of the incremental consumption of resources for the diagnosis and treatment of anastomotic leak (AL) in patients after resection with anastomosis for colorectal cancer compared to patients without AL on the Spanish health system. Method This study included a literature review with parameters validated by experts and the development of a cost analysis model to estimate the incremental resource consumption of patients with AL versus those without. The patients were divided into three groups: 1) colon cancer (CC) with resection, anastomosis and AL; 2) rectal cancer (RC) with resection, anastomosis without protective stoma and AL; and 3) RC with resection, anastomosis with protective stoma and AL. Results The average total incremental cost per patient was €38,819 and €32,599 for CC and RC, respectively. The cost of AL diagnosis per patient was €1018 (CC) and €1030 (RC). The cost of AL treatment per patient in Group 1 ranged from €13,753 (type B) to €44,985 (type C + stoma), that in Group 2 ranged from €7348 (type A) to €44,398 (type C + stoma), and that in Group 3 ranged from €6197 (type A) to €34,414 (type C). Hospital stays represented the highest cost for all groups. In RC, protective stoma was found to minimize the economic consequences of AL. Conclusions The appearance of AL generates a considerable increase in the consumption of health resources, mainly due to an increase in hospital stays. The more complex the AL, the higher the cost associated with its treatment. Interest of the study it is the first cost-analysis study of AL after CR surgery based on prospective, observational and multicenter studies, with a clear, accepted and uniform definition of AL and estimated over a period of 30 days.