Cost-effectiveness of endoscopic ultrasound-guided coils plus cyanoacrylate injection compared to endoscopic cyanoacrylate injection in the management of gastric varices

作     者：Carlos Robles-Medranda Joao Autran Nebel Miguel Puga-Tejada Roberto Oleas Jorge Baquerizo-Burgos Jesenia Ospina-Arboleda Manuel Valero Hannah Pitanga-Lukashok 

作者机构：Gastroenterology and Endoscopy DivisionInstituto Ecuatoriano de Enfermedades DigestivasGuayaquil 090505GuayasEcuador 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第1期

页      面：13-23页

学科分类：1007[医学-药学(可授医学、理学学位)] 10[医学] 

主　　题：Cost-effectiveness Endoscopic ultrasound-guided therapy Gastric varices Gastrointestinal bleeding Hemostasis Therapy 

摘      要：BACKGROUND Cyanoacrylate(CYA)injection can be performed using a standard upper endoscopy technique or under endoscopic ultrasound(EUS)guidance alone or in combination with *** is little information available on the economic impact of these treatment *** To compare the cost-effectiveness of treating gastric varices by CYA injection via upper endoscopy vs coils plus CYA guided by *** This was an observational,descriptive,and retrospective *** were allocated into two groups:A CYA group and coils plus CYA *** baseline characteristics were compared,and a cost analysis was *** Overall,36 patients were included(19 in the CYA group and 17 in the coils+CYA group).All patients in the CYA group had acute *** underwent a higher mean number of procedures(1.47 vs 1,P=0.025),and the mean volume of glue used was 2.15 vs 1.65 mL,P=*** coils+CYA group showed a higher technical success rate(100%vs 84.2%),with a complication rate similar to the CYA *** majority of CYA patients required hospitalization,and although the mean total per procedure cost was lower(United States$1350.29 vs United States$2978),the mean total treatment cost was significantly different(United States$11060.89 for CYA vs United States$3007.13 for coils+CYA,P=0.03).CONCLUSION The use of EUS-guided coils plus cyanoacrylate is more cost-effective than cyanoacrylate injection when the total costs are ***,randomized trials are needed to validate the cost-effectiveness of the EUS-guided approach to treat gastric varices.