A fém- és műanyag stentek költséghatékonysága malignus epeúti szűkületek esetében – összehasonlító vizsgálat

Author:

Daróczi Tímea1,Bor Renáta1,Fábián Anna1,Szabó Ella1,Farkas Klaudia1,Bálint Anita1,Czakó László1,Rutka Mariann1,Szűcs Mónika2,Milassin Ágnes1,Molnár Tamás1,Szepes Zoltán1

Affiliation:

1. I. Belgyógyászati Klinika, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged, Korányi fasor 8–10., 6720

2. Orvosi Fizika és Orvosi Informatika Intézet, Szegedi Tudományegyetem, Általános Orvostudományi Kar Szeged

Abstract

Introduction: Self-expandable metal and plastic stents can be applied in the palliative endoscopic treatment of patients with unresectable malignant biliary obstruction. The use of metal stentsis recommended if the patient’s life expectancy is more than four months. Aim: To compare the therapeutic efficacy and cost-effectiveness of metal and plastic stents in the treatment of malignant biliary obstruction. Method: The authorsretrospectively enrolledpatients who received metal (37 patients) or plastic stent (37 patients). The complication rate, stent patency and cumulative cost of treatment were assessed in the two groups. Results: The complication rate of metal stents was lower (37.84% vs. 56.76%), but the stent patency was higher compared with plastic stents (19.11 vs. 8.29 weeks; p = 0.0041). In the plastic stent group the frequency of hospitalization of patients in context with stent complications (1.18 vs. 2.32; p = 0.05) and the necessity of reintervention for stent dysfunction (17 vs. 27; p = 0.033) were substantially higher. In this group multiple stent implantation raised the stent patency from 7.68 to 10.75 weeks. There was no difference in the total cost of treatment of malignant biliary obstruction between the two groups (p = 0.848). Conclusions: Considering the cost of treatment and the burden of patients the authors recommend self-expandable metal sten timplantation if the life expectancy of patients is more than two months. In short survival cases multiple plastic stent implantation is recommended. Orv. Hetil., 2016, 157(7), 268–274.

Publisher

Akademiai Kiado Zrt.

Subject

General Medicine

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