Evidence map›Paper›PMID 38850445›Full record

ArticleTechniques in coloproctology2024

A retrospective cohort study of intra-corporeal versus extra-corporeal anastomosis for right hemicolectomy with cost-effectiveness analysis.

I Seow-En, I E-H Tan, V Zheng, J Wu, Y Zhao, K A Ang, M K H Au, E J K W Tan

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

I Seow-EnDepartment of Colorectal Surgery, Singapore General Hospital, Outram Road, 169608, Singapore. isaac.seow.en@gmail.com.ORCID 0000-0001-8287-6812
I E-H TanGroup Finance Analytics, Singapore Health Services, Singapore, Singapore.ORCID 0000-0002-0000-1367
V ZhengYong Loo Lin School of Medicine, National University of Singapore, Medical Drive, 117597, Singapore.ORCID 0000-0003-0883-2605
J WuDepartment of Colorectal Surgery, Singapore General Hospital, Outram Road, 169608, Singapore.ORCID 0000-0003-3485-1180
Y ZhaoGroup Finance Analytics, Singapore Health Services, Singapore, Singapore.ORCID 0000-0003-4093-4695
K A AngFinance, Singapore General Hospital, Outram Road, 169608, Singapore.ORCID 0000-0001-7465-841X
M K H AuGroup Finance Analytics, Singapore Health Services, Singapore, Singapore.ORCID 0000-0003-3653-0962
E J K W TanDepartment of Colorectal Surgery, Singapore General Hospital, Outram Road, 169608, Singapore.ORCID 0000-0002-0771-5063

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe aimed to compare outcomes and cost effectiveness of extra-corporeal anastomosis (ECA) versus intra-corporeal anastomosis (ICA) for laparoscopic right hemicolectomy using the National Surgical Quality Improvement Programme data.

methodsPatients who underwent elective laparoscopic right hemicolectomy for colon cancer from January 2018 to December 2022 were identified. Non-cancer diagnoses, emergency procedures or synchronous resection of other organs were excluded. Surgical characteristics, peri-operative outcomes, long-term survival and hospitalisation costs were compared. Incremental cost-effectiveness ratio (ICER) was used to evaluate cost-effectiveness.

resultsA total of 223 patients (175 ECA, 48 ICA) were included in the analysis. Both cohorts exhibited comparable baseline patient, comorbidity, and tumour characteristics. Distribution of pathological TMN stage, tumour largest dimension, total lymph node harvest and resection margin lengths were statistically similar. ICA was associated with a longer median operative duration compared with ECA (255 min vs. 220 min, P < 0.001). There was a quicker time to gastrointestinal recovery, with a shorter median hospital stay in the ICA group (4.0 versus 5.0 days, P = 0.001). Overall complication rates were comparable. ICA was associated with a higher surgical procedure cost (£6301.57 versus £4998.52, P < 0.001), but lower costs for ward accommodation (£1679.05 versus £2420.15, P = 0.001) and treatment (£3774.55 versus £4895.14, P = 0.009), with a 4.5% reduced overall cost compared with ECA. The ICER of -£3323.58 showed ICA to be more cost effective than ECA, across a range of willingness-to-pay thresholds.

conclusionICA in laparoscopic right hemicolectomy is associated with quicker post-operative recovery and may be more cost effective compared with ECA, despite increased operative costs.

Indexed as

Anastomosis, SurgicalColectomyColonic NeoplasmsLaparoscopyOperative TimeAgedCost-Effectiveness AnalysisElective Surgical ProceduresFemaleHospital CostsHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesCost-effectiveness analysisExtra-corporeal anastomosisIntra-corporeal anastomosisRight hemicolectomy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.