Published online Oct 16, 2023. doi: 10.4253/wjge.v15.i10.593
Peer-review started: July 6, 2023
First decision: August 4, 2023
Revised: August 23, 2023
Accepted: September 11, 2023
Article in press: September 11, 2023
Published online: October 16, 2023
Processing time: 96 Days and 0.1 Hours
Laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM) are two effective procedures for treating achalasia. Given the rising healthcare costs and their impact on patients and society, comparing their cost-effectiveness becomes crucial in determining the preferred management option. This research contrasts the initial procedure and short-term (1-year) costs of both techniques at a tertiary academic care center.
This study focuses on comparing the clinical outcomes and costs of LHM and POEM as treatments for achalasia. The key issue addressed is the lack of direct cost-effectiveness comparisons between these procedures despite their similar clinical efficacy. By demonstrating that POEM is not only clinically effective but also economically favorable due to shorter pro
This study’s primary aim was to compare clinical outcomes and costs between LHM and POEM for achalasia. The achieved objectives include demonstrating equivalent clinical efficacy and revealing cost advantages associated with POEM, attributed to shorter procedure times and hospital stays. These realized goals provide crucial insights for future research, emphasizing the need to consider both clinical effectiveness and economic implications when making treatment decisions for achalasia.
The study employed a retrospective chart review method to achieve its objectives. Patient data from electronic medical records were analyzed to compare clinical outcomes and costs of LHM and POEM for achalasia. Novel aspects of the research methods included a detailed cost analysis that incorporated time-based operating room (OR) and anesthesia costs, along with a comprehensive examination of various cost categories. This approach provides a unique perspective on cost-effectiveness, highlighting the potential impact of shorter procedure times and hospital stays on overall costs.
The research findings underscored the comparable clinical efficacy of LHM and POEM for achalasia treatment, as evidenced by similar post-procedure Eckardt scores. Importantly, the study revealed a significant cost advantage of POEM over LHM, primarily attributed to shorter procedure times and hospital stays. This cost-effectiveness insight provides a valuable contribution to the field, highlighting the need for a holistic approach to treatment decisions. While the study addressed the immediate costs associated with the procedures, future research should delve into long-term cost patterns and their implications.
The innovative aspect lies in its detailed cost analysis, incorporating time-based OR and anesthesia costs, and its emphasis on considering both clinical effectiveness and economic implications when making treatment decisions. While not introducing new methods, the study’s novelty comes from its comprehensive examination of cost categories and the recognition of the significance of shorter procedure times and hospital stays in influencing cost-effectiveness.
The direction of future research in this field should encompass larger prospective studies with extended follow-up periods to validate the long-term cost-effectiveness and clinical outcomes of LHM and POEM procedures for achalasia. Additionally, investigating the evolving costs as POEM becomes more commonplace in endoscopy suites, as well as exploring variations in costs associated with individual achalasia subtypes, could provide valuable insights for informed treatment decisions.