OBJECTIVES:

The objective of this study is to compare the cost-effectiveness of the Echelon circular powered stapler (ECPS) versus the manual circular stapler (MCS) for colorectal anastomosis.

METHODS:

A cost-effectiveness study was conducted to assess the most efficient device for colorectal anastomosis. The data was obtained from a cohort study of 451 patients. The ECPS cases were matched to MCS cases by propensity score matching to obtain comparable groups of patients. Three hundred and thirty patients with colorectal cancer were finally included in the study to obtain the probabilities of effectiveness in the model.

Direct costs in the study include costs for: operating room, device (stapler), type of surgery, re-interventions, medication, laboratory, complications and follow-up consultations for each of the treatments.

A decision tree was used to determine the cost per patient for each type of circular stapler used and the incremental cost-effectiveness ratio (ICER) by patient without anastomotic complications. A Monte Carlo analysis was also performed as a sensitivity analysis to confirm the robustness of the results.

RESULTS:

The effectiveness for patients treated with ECPS was 97%, while the effectiveness of MCS group was 93%. The cost per patient for ECPS treatment is 6092.83 € and 9098.61 € for MCS. The ICER was -68796.20 € per patient without anastomotic complications.

CONCLUSIONS:

According to these results, the cost-effectiveness study shows that the application of the Echelon circular powered stapler stapler (ECPS) has a greater effectiveness and a lower cost per patient compared to current manual circular staplers (MCS).