当前位置： SCI文献检索 > DIGESTIVE DISEASES AND SCIENCES期刊下所有文献 > Colectomy with Permanent End Ileostomy Is More Cost-Effective than Ileal Pouch-Anal Anastomosis for Crohn's Colitis.

Colectomy with Permanent End Ileostomy Is More Cost-Effective than Ileal Pouch-Anal Anastomosis for Crohn's Colitis.

Abstract：

BACKGROUND:Much of the economic burden of Crohn's disease (CD) is related to surgery. Twenty percent of patients with CD have isolated colonic disease. While permanent end ileostomy (EI) is generally the procedure of choice for patients with refractory CD colitis, single-center experiences suggest that restorative proctocolectomy (IPAA) is durable in select patients. AIMS:We assessed the cost-effectiveness of total colectomy with permanent EI versus IPAA in medically refractory colonic CD. METHODS:We used a lifetime Markov model with 6-month cycles to simulate quality-adjusted life years (QALYs) and cost. In each of the EI and IPAA strategies, patients could transition between multiple health states. One-way and multivariable sensitivity analysis and tornado analysis were performed to identify thresholds for factors influencing cost-effectiveness. RESULTS:IPAA was more effective than EI surgery with an incremental cost-effectiveness ratio of $70,715 per QALY gained. We identified the following variables of importance in our model: (1) the cost of the EI surgery, (2) the cost of infliximab, and (3) the cost of gastroenterology ambulatory visit and labs. Threshold analysis revealed that if the costs associated with EI surgery exceeded $20,167 or if the utility of IPAA with CD remission without medical therapy exceeded 0.37, IPAA became the more cost-effective strategy. CONCLUSIONS:In patients with medically refractory CD isolated to the colon, colectomy with permanent EI is more cost-effective than IPAA unless the costs associated with the EI surgery exceed $20,167 or if the utility associated with IPAA and CD remission exceeds 0.37.

journal_name

Dig Dis Sci

journal_title

Digestive diseases and sciences

authors

Taleban S,Van Oijen MG,Vasiliauskas EA,Fleshner PR,Shen B,Ippoliti AF,Targan SR,Melmed GY

doi

10.1007/s10620-015-3886-3

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

550-9

issue

2

eissn

0163-2116

issn

1573-2568

pii

10.1007/s10620-015-3886-3

journal_volume

61

pub_type

杂志文章

相关文献

DIGESTIVE DISEASES AND SCIENCES文献大全
  • Cumulative Inflammation Could Be a Risk Factor for Intestinal Failure in Crohn's Disease.

    abstract：BACKGROUND:Intestinal failure is the most critical complication of Crohn's disease. Intestinal failure requires home parenteral nutrition, which worsens the quality of life of the patients and sometimes causes life-threatening complications. AIMS:The purpose of this study was to investigate the incidence and risk fact...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-019-05553-2

    authors： Watanabe Y,Miyoshi N,Fujino S,Takahashi H,Haraguchi N,Hata T,Matsuda C,Yamamoto H,Doki Y,Mori M,Mizushima T

    更新日期：2019-08-01 00:00:00

  • Hepatic glucose uptake is increased in association with elevated serum γ-glutamyl transpeptidase and triglyceride.

    abstract：BACKGROUND:Subjects with fatty liver disease (FLD) can show increased hepatic 2-deoxy-2-((18)F)fluoro-D-glucose (FDG) uptake, but the role of hepatic inflammation has not been explored. AIMS:We investigated whether hepatic inflammatory response, as implicated by elevated serum markers, is associated with increased liv...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-013-2957-6

    authors： Hong SP,Noh TS,Moon SH,Cho YS,Lee EJ,Choi JY,Kim BT,Lee KH

    更新日期：2014-03-01 00:00:00

  • Transverse myelitis occurring in association with primary biliary cirrhosis and Sjogren's syndrome.

    abstract：:Transverse myelitis (TM) as a manifestation of an autoimmune disorder is relatively rare. In Sjogren's syndrome (SS), the occurrence of TM is remarkably uncommon. Only three cases have been reported associated with primary biliary cirrhosis (PBC). Here we report the fourth case of TM occurring in association with SS a...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章,评审

    doi：10.1023/a:1022821800714

    authors： Anantharaju A,Baluch M,Van Thiel DH

    更新日期：2003-04-01 00:00:00

  • Race and inflammatory bowel disease in an urban healthcare system.

    abstract：BACKGROUND:Inflammatory bowel disease (IBD) is increasingly common among non-Caucasian populations, but interracial differences in disease characteristics and management are not well-characterized. AIMS:We tested the hypothesis that disease characteristics and management vary by race among IBD patients in an ethnicall...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-010-1442-8

    authors： Sewell JL,Inadomi JM,Yee HF Jr

    更新日期：2010-12-01 00:00:00

  • Measurement of segmental transit through the gut in man. A novel approach by the biomagnetic method.

    abstract：:The techniques commonly used to evaluate the transit of contents through the gut feature some limitations for being either inaccurate, invasive, inconvenient, or potentially dangerous for the subjects. Aim of this study was to establish a safe, noninvasive and accurate technique for the measurement of segmental oroana...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01296499

    authors： Basile M,Neri M,Carriero A,Casciardi S,Comani S,Del Gratta C,Di Donato L,Di Luzio S,Macri MA,Pasquarelli A

    更新日期：1992-10-01 00:00:00

  • Production of a polar metabolite of 1,25-dihydroxyvitamin D3 in a rat liver perfusion system.

    abstract：:When radiolabeled 1,25-dihydroxyvitamin D3 is added to the perfusion medium of a rat liver perfusion system, a polar metabolite of 1,25-dihydroxyvitamin D3 is formed in the liver and excreted in the bile. Addition of radiolabeled 1,25-dihydroxyvitamin D3 to the perfusion medium without a liver in the circuit results i...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01391637

    authors： Kumar R,Nagubandi S,Londowski JM

    更新日期：1981-03-01 00:00:00

  • New enema treatments for inflammatory bowel disease.

    abstract：:Two new preparations are under clinical trial for use in the treatment of ulcerative proctitis and left-sided colitis. One is 5-aminosalicylate, a component of sulfasalazine. This substance has virtually no immunomodulating capabilities. Evidence for efficacy equal to that of sulfasalazine in acute colitis has been ob...

    journal_title：Digestive diseases and sciences

    pub_type： 临床试验,杂志文章

    doi：10.1007/BF01538136

    authors： Karp LC,Targan SR

    更新日期：1988-03-01 00:00:00

  • Effect of lactate and H+ on structure and function of rat intestine.

    abstract：:Segments of rat ileum and colon were infused in vivo to test if 0.1 M lactate, 10(-4) M H+, or both altered mucosal structure and function. In the first series of experiments, lactate concentration was kept at 0.1 M while H+ was varied from 10(-4) to 10(-7) M. Lactate and 10(-4) M H+ in the colon, and lactate and 10(-...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01308119

    authors： Saunders DR,Sillery J

    更新日期：1982-01-01 00:00:00

  • High Incidence of Recurrent Crohn's Disease Following Colectomy for Ulcerative Colitis Revealed with Long Follow-Up.

    abstract：BACKGROUND AND AIMS:Ulcerative colitis (UC) patients with progression of their disease despite optimized medical therapy may warrant "curative" proctocolectomy with end ileostomy or ileo-anal pouch (IPAA) anastomosis. The aim of our study was to assess the incidence of later recurrent ileitis that lead to altering the ...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-017-4873-7

    authors： Shamah S,Schneider J,Korelitz BI

    更新日期：2018-02-01 00:00:00

  • Evaluation of cytoprotection against ethanol-induced injury in gastric mucosa pretreated with misoprostol, cimetidine, or placebo.

    abstract：:The authors have developed a primate model for evaluating cytoprotection against alcohol-induced injury in gastric mucosa pretreated with antiulcer agents. In the present study, groups of squirrel monkeys received either a single oral dose of misoprostol (500 or 200 micrograms/kg), cimetidine (3 or 6 mg/kg), placebo, ...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01309333

    authors： Liss RH,Letourneau RJ,Schepis JP

    更新日期：1986-02-01 00:00:00

  • Tachykinins and in vivo gut motility.

    abstract：:The gut smooth muscle in the intact conscious state exhibits three distinct types of contractions: rhythmic phasic contractions, tone, and ultrapropulsive contractions. The motility functions of these contractions differ markedly. The phasic contractions mix and propel the ingested food in an orderly fashion so that t...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章,评审

    doi：

    authors： Sarna SK

    更新日期：1999-08-01 00:00:00

  • Gastroesophageal sphincter pressure and histological changes in distal esophagus in patients with achalasia of the esophagus.

    abstract：:A prospective study was performed in 17 patients with achalasia of the esophagus determining the manometric characteristics of the gastroesophageal sphincter, correlating it with histological analysis by biopsies taken during surgery at the distal narrowed segment of the esophagus, at the location of the sphincter. Th...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01308293

    authors： Csendes A,Smok G,Braghetto I,Ramirez C,Velasco N,Henriquez A

    更新日期：1985-10-01 00:00:00

  • Rebamipide prevents indomethacin-induced gastric mucosal lesion formation by inhibiting activation of neutrophils in rats.

    abstract：:Since granulocyte elastase has been shown to be involved in the pathogenesis of gastric mucosal lesion formation induced by nonsteroidal antiinflammatory drugs, inhibition of granulocyte elastase release from neutrophils may be useful in the prevention of these lesions. The objective of this study was to determine whe...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：

    authors： Murakami K,Okajima K,Harada N,Isobe H,Okabe H

    更新日期：1998-09-01 00:00:00

  • Premature Birth and Large for Gestational Age Are Associated with Risk of Barrett's Esophagus in Adults.

    abstract：BACKGROUND:Birth characteristics, including weight and gestational age, may be associated with risk of Barrett's esophagus (BE), the only known precursor for esophageal adenocarcinoma; however, data are limited. AIMS:To examine associations between various birth characteristics and BE, and whether these associations a...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-015-3967-3

    authors： Shiota S,El-Serag HB,Thrift AP

    更新日期：2016-04-01 00:00:00

  • Induction and activation of adaptive immune populations during acute and chronic phases of a murine model of experimental colitis.

    abstract：BACKGROUND:Dextran sodium sulphate (DSS) is commonly used to induce intestinal inflammation in rodents. Despite its continuing importance as a model system for examining IBD pathogenesis, the mucosal and systemic immune responses have not been comprehensively documented. AIMS:The purpose of this study was to dissect f...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-010-1240-3

    authors： Hall LJ,Faivre E,Quinlan A,Shanahan F,Nally K,Melgar S

    更新日期：2011-01-01 00:00:00

  • Gastric acid inhibits antral phase III activity in duodenal ulcer patients.

    abstract：:Fourteen patients with duodenal ulcers and eight healthy volunteers were examined to measure interdigestive gastroduodenal motility and plasma motilin. In order to study the effects of gastric acid on the gastroduodenal motility, 20 mg of famotidine was administered intravenously. The motility index of the gastric ant...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01295907

    authors： Kusano M,Sekiguchi T,Nishioka T,Kawamura O,Kikuchi K,Matsuzaki T,Horikoshi T

    更新日期：1993-05-01 00:00:00

  • Peritoneal sarcoidosis. An unrecognized cause of sclerosing peritonitis.

    abstract：:In a Caucasian woman with a history of ocular and pulmonary sarcoidosis, the occurrence of sclerosing peritonitis with exudative ascites but without any of the well-known causes of this syndrome prompts us to consider that sclerosing peritonitis is a manifestation of sarcoidosis. The dramatic improvement that occurred...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01299875

    authors： Ngô Y,Messing B,Marteau P,Nouël O,Pasquiou A,Lavergne A,Rambaud JC

    更新日期：1992-11-01 00:00:00

  • Involvement of alpha(2)-adrenoceptors in the gastric protective effect of nitroglycerin against acidified ethanol-induced mucosal injury.

    abstract：:Clinical observations reveal that alcohol intake is associated with an increase in upper gastrointestinal hemorrhage requiring hospitalization and that nitroglycerin or long-acting nitrates lower this risk. Nitroglycerin, a gastric vasodilator that can increase gastric fluid volume, protects the rodent stomach against...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-006-9692-1

    authors： Leung FW,Chan CC

    更新日期：2007-11-01 00:00:00

  • Lack of adaptive changes in human pancreatic amylase and lipase secretion in response to high-carbohydrate, low-fat diet applied by a 10-day continuous intraduodenal infusion.

    abstract：:In order to investigate whether the human exocrine pancreas is capable of adapting to a diet with a high-carbohydrate, low-fat, and normal protein content, 10 healthy subjects were given a continuous intraduodenal infusion of such a dietary composition (8760 kJ in 2400 ml/day) via a portable infusion pump over a perio...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01347884

    authors： Emde C,Liehr RM,Gregor M,Pleul O,Riecken EO,Menge H

    更新日期：1985-03-01 00:00:00

  • Hepatitis A, hepatitis B, and combination hepatitis vaccines for immunoprophylaxis: an update.

    abstract：:Since the publication of the last extensive review of hepatitis vaccines, use of inactivated hepatitis A vaccines has been extended to high-risk regions of the United States and specific patient groups, such as those with chronic liver disease, and use of the recombinant hepatitis B vaccines has been recommended for o...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章,评审

    doi：10.1023/a:1015397807278

    authors： Koff RS

    更新日期：2002-06-01 00:00:00

  • Effects of prostaglandin E2 on gastric irritant-induced apoptosis.

    abstract：:We previously reported that various gastric irritants induced both apoptosis and necrosis in cultured gastric mucosal cells. In a continuation of this work, the present study has examined the effects of prostaglandin E2 (PGE2), a cytoprotective factor for gastric mucosa in vivo, on gastric irritant-induced apoptosis a...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1023/a:1020164000898

    authors： Hoshino T,Takano T,Tsutsumi S,Tomisato W,Tsuchiya T,Mizushima T

    更新日期：2002-10-01 00:00:00

  • Hypermethylation of ACP1, BMP4, and TSPYL5 in Hepatocellular Carcinoma and Their Potential Clinical Significance.

    abstract：BACKGROUND AND AIM:Aberrant methylation of specific genes is frequent event in hepatocellular carcinoma (HCC). Our present study aims to explore the methylation levels of acid phosphatase locus 1 (ACP1), bone morphogenetic protein 4 (BMP4), and testis-specific protein, Y-encoded-like 5 (TSPYL5) and their potential clin...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-015-3878-3

    authors： Qiu X,Hu B,Huang Y,Deng Y,Wang X,Zheng F

    更新日期：2016-01-01 00:00:00

  • Enzymatic liver function capacity correlates with disease severity of patients with liver cirrhosis: a study with the LiMAx test.

    abstract：BACKGROUND:Assessment and quantification of actual liver function is crucial in patients with chronic liver disease to monitor disease progression and predict individual prognosis. Mathematical models, such as model for end-stage liver disease, are used for risk stratification of patients with chronic liver disease but...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-014-3250-z

    authors： Malinowski M,Jara M,Lüttgert K,Orr J,Lock JF,Schott E,Stockmann M

    更新日期：2014-12-01 00:00:00

  • Maturation of antroduodenal motor activity in preterm and term infants.

    abstract：:Previous studies have shown that duodenal motility patterns differ in preterm and term infants, but antral motor activities were not compared. Using a validated, low-compliance, continuous-perfusion, neonatal manometric system, antral and duodenal motility was studied in 19 preterm and nine term infants. Antral motili...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01308336

    authors： Ittmann PI,Amarnath R,Berseth CL

    更新日期：1992-01-01 00:00:00

  • Role of hepatitis delta virus infection in hepatocellular carcinoma.

    abstract：:Hepatitis B virus (HBV) DNA integrates into the host DNA and shows a series of potentially oncogenetic properties, but HBV is not an acutely transforming virus, because HCC develops decades after infection. Other factors, namely cirrhosis, inflammation, alcohol intake, and viral superinfections, could promote the onco...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01297460

    authors： Verme G,Brunetto MR,Oliveri F,Baldi M,Forzani B,Piantino P,Ponzetto A,Bonino F

    更新日期：1991-08-01 00:00:00

  • Further steps of hepatic stimulatory substance purification.

    abstract：:The hepatic stimulatory substance (HSS) extracted from weanling rat livers was purified 381,000-fold using chromatographic techniques including nondissociating polyacrylamide gel electrophoresis (nondenaturing PAGE). The activity of this highly purified HSS, named Acr-F4, was assessed in two in vivo models. In 40% hep...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/BF01297037

    authors： Francavilla A,Barone M,Van Thiel DH,Mazzaferro V,Prelich JG,Starzl TE

    更新日期：1991-05-01 00:00:00

  • Usefulness of assessing circulating levels of resistin, ghrelin, and IL-18 in alcoholic acute pancreatitis.

    abstract：OBJECTIVES:Acute pancreatitis (AP) is a severe inflammatory disease with high mortality and morbidity rates. We have previously demonstrated that resistin may represent an early marker of inflammation in AP. It was also revealed that ghrelin may have anti-inflammatory potential. However, the role of adipohormones in AP...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-009-1106-8

    authors： Daniel P,Leśniowski B,Jasińska A,Pietruczuk M,Małecka-Panas E

    更新日期：2010-10-01 00:00:00

  • Preoperative antimicrobial administration for prevention of postoperative infection in patients with laparoscopic cholecystectomy.

    abstract：:The present study was designed to investigate whether the administration of antimicrobial agents before laparoscopic cholecystectomy (LC) is more effective for prevention of postoperative infection. During the period from January 1991 to September 2001, 397 patients treated with sulbactam/cefoperazone (SBT/CPZ) for pr...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1023/a:1026114203622

    authors： Uchiyama K,Kawai M,Onishi H,Tani M,Kinoshita H,Ueno M,Yamaue H

    更新日期：2003-10-01 00:00:00

  • The Jagged-1/Notch-1/Hes-1 pathway is involved in intestinal adaptation in a massive small bowel resection rat model.

    abstract：BACKGROUND:Notch signaling is required for the maintenance of intestinal epithelial proliferation. Dysfunction of this signaling pathway is associated with the loss of proliferated crypt epithelial cells. AIM:The aim of this study was to investigate the role of Notch signaling in small bowel resection (SBR)-associated...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-013-2680-3

    authors： Chen G,Sun L,Yu M,Meng D,Wang W,Yang Y,Yang H

    更新日期：2013-09-01 00:00:00

  • Is use of PPIs related to increased intraepithelial lymphocytes in the colon?

    abstract：BACKGROUND:The use of proton pump inhibitors (PPIs) is thought to increase the incidence of microscopic colitis (MC), although the exact mechanisms are not fully understood. Increased infiltration of intraepithelial lymphocytes (IELs) is a pathologic finding of MC (including collagenous or lymphocytic colitis). AIMS:W...

    journal_title：Digestive diseases and sciences

    pub_type： 杂志文章

    doi：10.1007/s10620-012-2315-0

    authors： Yu YH,Han DS,Choi EY,Park HS,Jeong JY,Eun CS,Oh YH,Pyo JY

    更新日期：2012-10-01 00:00:00