Robles-Medranda C, Nebel JA, Puga-Tejada M, Oleas R, Baquerizo-Burgos J, Ospina-Arboleda J, Valero M, Pitanga-Lukashok H. Cost-effectiveness of endoscopic ultrasound-guided coils plus cyanoacrylate injection compared to endoscopic cyanoacrylate injection in the management of gastric varices. World J Gastrointest Endosc 2021; 13(1): 13-23 [PMID: 33520103 DOI: 10.4253/wjge.v13.i1.13]
Corresponding Author of This Article
Carlos Robles-Medranda, MD, Chief Doctor, Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Av. Abel Romeo Castillo y Av. Juan Tanca Marengo, Torre Vitalis, Mezzanine 3, Guayaquil 090505, Guayas, Ecuador. carlosoakm@yahoo.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jan 16, 2021; 13(1): 13-23 Published online Jan 16, 2021. doi: 10.4253/wjge.v13.i1.13
Cost-effectiveness of endoscopic ultrasound-guided coils plus cyanoacrylate injection compared to endoscopic cyanoacrylate injection in the management of gastric varices
Carlos Robles-Medranda, Joao Autran Nebel, Miguel Puga-Tejada, Roberto Oleas, Jorge Baquerizo-Burgos, Jesenia Ospina-Arboleda, Manuel Valero, Hannah Pitanga-Lukashok
Carlos Robles-Medranda, Joao Autran Nebel, Miguel Puga-Tejada, Roberto Oleas, Jorge Baquerizo-Burgos, Jesenia Ospina-Arboleda, Manuel Valero, Hannah Pitanga-Lukashok, Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil 090505, Guayas, Ecuador
Author contributions: Robles-Medranda C and Pitanga-Lukashok H contributed to concept, design, definition of intellectual content, manuscript editing and manuscript review; Nebel JA, Oleas R, Valero M, and Ospina J contributed to data acquisition, literature search, manuscript preparation; Puga-Tejada M and Baquerizo-Burgos J contributed to statistical analysis, manuscript preparation, manuscript editing and manuscript review.
Institutional review board statement: This study was reviewed and approved by the Instituto Ecuatoriano de Enfermedades Digestivas Institutional Review Board.
Informed consent statement: Informed written consent was provided from all study participants or their legal guardians for attendance and research purposes.
Conflict-of-interest statement: Carlos Robles-Medranda is a key opinion leader and consultant for Pentax Medical, Boston Scientific, G-tech medical supply and MD consulting group. The other authors have nothing to disclose.
Data sharing statement: All available data can be requested by contacting the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Carlos Robles-Medranda, MD, Chief Doctor, Gastroenterology and Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas, Av. Abel Romeo Castillo y Av. Juan Tanca Marengo, Torre Vitalis, Mezzanine 3, Guayaquil 090505, Guayas, Ecuador. carlosoakm@yahoo.es
Received: October 6, 2020 Peer-review started: October 6, 2020 First decision: December 1, 2020 Revised: December 9, 2020 Accepted: December 16, 2020 Article in press: December 16, 2020 Published online: January 16, 2021 Processing time: 95 Days and 16.9 Hours
Core Tip
Core Tip: There is little evidence regarding the economic impact of standard endoscopic cyanoacrylate therapy vs endoscopic ultrasound (EUS)-guided endovascular therapy in the management of gastric varices. In this retrospective study, we found that patients treated with endoscopic cyanoacrylate injection required hospitalization and had a significantly higher total treatment cost in comparison to those treated with an EUS-guided therapy. The incremental cost-effectiveness ratio analysis shows that in endoscopic therapy, each early rebleeding, adverse events, and day of hospitalization increased health-related costs on United States $ 2670.80, United States $ 8012.40, United States $ 127.18 per presented event, respectively, when comparing with coils + cyanoacrylate group cost and presented events. Each inevitable death on the endoscopic group represented a health-related cost increase on United States $ 8012.40 in comparison with EUS-guided therapy.
