Clinical and economic efficiency of the loop ileostomy closure by various methods

Abstract

in the context of optimizing the financial mechanisms of the national healthcare system, introducing the single-channel financial principle and further developing the insurance-based medicine in Russia, a competent financial accounting becomes an important element of the entire healthcare system.Aim – compare the economic effectiveness of various methods of closing a loop ileostomy.Materials and methods. The study included 327 patients randomized into 3 groups. in group 1, the closure of an ileostomy was performed manually with the formation of an end-to-end ileo-ileoastomosis; in group 2, the anastomosis was formed in the ”side by side” manner; and in group 3, a semi-automated surgical technique was used for the anastomosis formation.Results. The average cost of the treatments (per patient) in groups 1 and 2 was 131,704.90 rubles. and 145,473.70 rubles, respectively, while in group 3, the cost was higher – 167,443,60 rubles (p <0,001). This cost increase in Group 3 was mainly due to the cost of a disposable stapler and cassettes.Conclusion. The formation of a manual ileoileoanastomosis of the end-to-end type was less budget-consuming in comparison with the other methods. The semi-automated procedure based on disposable parts was the most expensive method of closing a loop ileostomy.

Keywords

• loop ileostomy closure
• reversal ileostomy closure
• ileostomy closure
• manually sutured anastomosis
• stapled anastomosis
• ileostomy closure cost