Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Radiologia Brasileira (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842019000500305 |
Resumo: | Abstract Objective: To compare two percutaneous techniques used in the treatment of malignant obstructive uropathy-antegrade double-J stent placement (JJ stenting) and percutaneous nephrostomy-in terms of their cost-effectiveness, from the perspective of the Brazilian public health care system. Materials and Methods: In this cost-effectiveness analysis, we employed decision-analytic modeling. We calculated material costs from 2017 factory prices listed by the Brazilian Pharmaceutical Market Regulatory Board (for medications) and published in the journal Revista Simpro (for medical devices). Procedure-related costs were evaluated, as were the rates of technical and clinical success. Those measures were then used as inputs for a cost-effectiveness analysis comparing the two procedures. Results: The sample comprised 41 patients, of whom 16 underwent antegrade JJ stenting (26 procedures) and 10 underwent percutaneous nephrostomy (15 procedures). Patient records, radiology reports, and expense reports of the interventional radiology department of the public hospital where the study was conducted were analyzed retrospectively. There were no significant complications: one patient had low back pain, and one had a transient retroperitoneal hematoma. The mean procedure time was 24 min, and clinical success (improvement in serum creatinine and resolution of hydronephrosis) was achieved in 97.5% of the cases. The average cost of JJ stenting was significantly lower than was that of percutaneous nephrostomy (US$164.10 vs. US$552.20). Conclusion: In the absence of any clinical contraindications, antegrade JJ stenting is a suitable alternative to both percutaneous nephrostomy and retrograde stenting in patients with dilated renal collecting systems secondary to malignant ureteral obstruction, providing significant cost savings and high success rates. |
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Radiologia Brasileira (Online) |
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Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care systemCost-benefit analysisRadiology, interventionalNephrostomy, percutaneousStentsAbstract Objective: To compare two percutaneous techniques used in the treatment of malignant obstructive uropathy-antegrade double-J stent placement (JJ stenting) and percutaneous nephrostomy-in terms of their cost-effectiveness, from the perspective of the Brazilian public health care system. Materials and Methods: In this cost-effectiveness analysis, we employed decision-analytic modeling. We calculated material costs from 2017 factory prices listed by the Brazilian Pharmaceutical Market Regulatory Board (for medications) and published in the journal Revista Simpro (for medical devices). Procedure-related costs were evaluated, as were the rates of technical and clinical success. Those measures were then used as inputs for a cost-effectiveness analysis comparing the two procedures. Results: The sample comprised 41 patients, of whom 16 underwent antegrade JJ stenting (26 procedures) and 10 underwent percutaneous nephrostomy (15 procedures). Patient records, radiology reports, and expense reports of the interventional radiology department of the public hospital where the study was conducted were analyzed retrospectively. There were no significant complications: one patient had low back pain, and one had a transient retroperitoneal hematoma. The mean procedure time was 24 min, and clinical success (improvement in serum creatinine and resolution of hydronephrosis) was achieved in 97.5% of the cases. The average cost of JJ stenting was significantly lower than was that of percutaneous nephrostomy (US$164.10 vs. US$552.20). Conclusion: In the absence of any clinical contraindications, antegrade JJ stenting is a suitable alternative to both percutaneous nephrostomy and retrograde stenting in patients with dilated renal collecting systems secondary to malignant ureteral obstruction, providing significant cost savings and high success rates.Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem2019-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842019000500305Radiologia Brasileira v.52 n.5 2019reponame:Radiologia Brasileira (Online)instname:Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)instacron:CBR10.1590/0100-3984.2018.0127info:eu-repo/semantics/openAccessTibana,Tiago KojunGrubert,Renata MottaSantos,Rômulo Florêncio TristãoFornazari,Vinicius Adami VayegoDomingos,André AlonsoReis,William TavaresMarchiori,EdsonNunes,Thiago Franchieng2019-10-21T00:00:00Zoai:scielo:S0100-39842019000500305Revistahttps://www.scielo.br/j/rb/https://old.scielo.br/oai/scielo-oai.phpradiologiabrasileira@cbr.org.br1678-70990100-3984opendoar:2019-10-21T00:00Radiologia Brasileira (Online) - Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR)false |
dc.title.none.fl_str_mv |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
title |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
spellingShingle |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system Tibana,Tiago Kojun Cost-benefit analysis Radiology, interventional Nephrostomy, percutaneous Stents |
title_short |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
title_full |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
title_fullStr |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
title_full_unstemmed |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
title_sort |
Percutaneous nephrostomy versus antegrade double-J stent placement in the treatment of malignant obstructive uropathy: a cost-effectiveness analysis from the perspective of the Brazilian public health care system |
author |
Tibana,Tiago Kojun |
author_facet |
Tibana,Tiago Kojun Grubert,Renata Motta Santos,Rômulo Florêncio Tristão Fornazari,Vinicius Adami Vayego Domingos,André Alonso Reis,William Tavares Marchiori,Edson Nunes,Thiago Franchi |
author_role |
author |
author2 |
Grubert,Renata Motta Santos,Rômulo Florêncio Tristão Fornazari,Vinicius Adami Vayego Domingos,André Alonso Reis,William Tavares Marchiori,Edson Nunes,Thiago Franchi |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Tibana,Tiago Kojun Grubert,Renata Motta Santos,Rômulo Florêncio Tristão Fornazari,Vinicius Adami Vayego Domingos,André Alonso Reis,William Tavares Marchiori,Edson Nunes,Thiago Franchi |
dc.subject.por.fl_str_mv |
Cost-benefit analysis Radiology, interventional Nephrostomy, percutaneous Stents |
topic |
Cost-benefit analysis Radiology, interventional Nephrostomy, percutaneous Stents |
description |
Abstract Objective: To compare two percutaneous techniques used in the treatment of malignant obstructive uropathy-antegrade double-J stent placement (JJ stenting) and percutaneous nephrostomy-in terms of their cost-effectiveness, from the perspective of the Brazilian public health care system. Materials and Methods: In this cost-effectiveness analysis, we employed decision-analytic modeling. We calculated material costs from 2017 factory prices listed by the Brazilian Pharmaceutical Market Regulatory Board (for medications) and published in the journal Revista Simpro (for medical devices). Procedure-related costs were evaluated, as were the rates of technical and clinical success. Those measures were then used as inputs for a cost-effectiveness analysis comparing the two procedures. Results: The sample comprised 41 patients, of whom 16 underwent antegrade JJ stenting (26 procedures) and 10 underwent percutaneous nephrostomy (15 procedures). Patient records, radiology reports, and expense reports of the interventional radiology department of the public hospital where the study was conducted were analyzed retrospectively. There were no significant complications: one patient had low back pain, and one had a transient retroperitoneal hematoma. The mean procedure time was 24 min, and clinical success (improvement in serum creatinine and resolution of hydronephrosis) was achieved in 97.5% of the cases. The average cost of JJ stenting was significantly lower than was that of percutaneous nephrostomy (US$164.10 vs. US$552.20). Conclusion: In the absence of any clinical contraindications, antegrade JJ stenting is a suitable alternative to both percutaneous nephrostomy and retrograde stenting in patients with dilated renal collecting systems secondary to malignant ureteral obstruction, providing significant cost savings and high success rates. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842019000500305 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842019000500305 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0100-3984.2018.0127 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem |
publisher.none.fl_str_mv |
Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem |
dc.source.none.fl_str_mv |
Radiologia Brasileira v.52 n.5 2019 reponame:Radiologia Brasileira (Online) instname:Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR) instacron:CBR |
instname_str |
Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR) |
instacron_str |
CBR |
institution |
CBR |
reponame_str |
Radiologia Brasileira (Online) |
collection |
Radiologia Brasileira (Online) |
repository.name.fl_str_mv |
Radiologia Brasileira (Online) - Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR) |
repository.mail.fl_str_mv |
radiologiabrasileira@cbr.org.br |
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1754208940246171648 |