Pelvic exenteration for chronic fistulating pelvic sepsis after multimodal treatment of pelvic malignancy

Brown, Kilian G.M.; Risbey, Charles; Solomon, Michael J.; Austin, Kirk K.S.; Lee, Peter J.; Byrne, Christopher M.

doi:10.1016/j.ejso.2023.107124

European Journal of Surgical Oncology

2023

DOI: 10.1016/j.ejso.2023.107124

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Pelvic exenteration for chronic fistulating pelvic sepsis after multimodal treatment of pelvic malignancy

Kilian G.M. Brown,

Charles Risbey,

Michael J. Solomon

et al.

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2024

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Cost Analysis of Pelvic Exenteration Surgery for Advanced Pelvic Malignancy

Risbey,

Brown,

Solomon

et al. 2024

Ann Surg Oncol

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Background Pelvic exenteration (PE) is a radical procedure involving multi-visceral resection for locally advanced pelvic malignancies. Such radical surgery is associated with prolonged operating theater time and hospital stay, as well as a substantial risk of postoperative complications, and therefore significant financial cost. This study aimed to comprehensively detail the inpatient cost of PE at a specialist center in the Australian public sector. Methods A retrospective costing review of consecutive PE operations at Royal Prince Alfred Hospital in Sydney between March 2014 and June 2022 was performed. Clinical data were extracted from a prospectively maintained database, and in-hospital costing data were provided by the hospital Performance Unit. All statistical analyses were performed using SPSS. Results Pelvic exenteration was performed for 461 patients, of whom 283 (61 %) had primary or recurrent rectal cancer, 160 (35 %) had primary or recurrent non-rectal cancer, and 18 (4 %) had a benign indication. The median admission cost was $108,259.4 ($86,620.8–$144,429.3) (Australian dollars [AUD]), with the highest costs for staffing followed by the operating room. Overall, admission costs were higher for complete PE (p < 0.001), PE combined with cytoreductive surgery (CRS) (p < 0.001), and older patients (p = 0.006). Discussion The total admission cost for patients undergoing PE reflects the complexity of the procedure and the multidisciplinary requirement. Patients of advanced age undergoing complete PE and PE combined with CRS incurred greater costs, but the requirement of a sacrectomy, vertical rectus abdominal flap reconstruction, major nerve or vascular excision, or repair were not associated with higher overall cost in the multivariate analysis.

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Cost Analysis of Pelvic Exenteration Surgery for Advanced Pelvic Malignancy

Risbey,

Brown,

Solomon

et al. 2024

Ann Surg Oncol

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Pelvic exenteration for chronic fistulating pelvic sepsis after multimodal treatment of pelvic malignancy

Cited by 1 publication

References 19 publications

Cost Analysis of Pelvic Exenteration Surgery for Advanced Pelvic Malignancy

Cost Analysis of Pelvic Exenteration Surgery for Advanced Pelvic Malignancy

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