wetenschapsdag 2023 | 103 Sessie 3d: Architecturale Hoogstandjes en Chirurgische Laagstandjes x1 Auteurs K. Wienholts, D.J. Nijssen, S. Sharabiany, P. J. Tanis, M. J. Postma, W. Lameris, R. Hompes Abstract titel Economic burden of pelvic sepsis after anastomotic leakage following rectal cancer surgery: a retrospective cost-ofillness analysis Background Anastomotic leakage (AL) following rectal surgery remains a challenging complication. Approximately half of these leakages persist past a year and can result in pelvic sepsis. Therapy is individualized, but can consist of vacuum drainage with anastomotic reconstruction or major salvage surgery. This requires additional admissions, interventions and operations, imposing a financial strain on the healthcare system. This study analyzes the financial burden for the extensive treatment of pelvic sepsis in a tertiary hospital. Methods Between January 2010 and January 2020, all patients referred for pelvic sepsis treatment after low anterior resection for rectal cancer were prospectively registered and retrospectively reviewed up to 5 years of follow-up (mean). Following guidelines for cost analyses from the Dutch National Healthcare Institute, this database was analyzed as a cost-of-illness study. Medical costs as imposed to the hospital were included, inflationadjusted to 2022, and measured in euros, starting at the first appointment in our hospital. Results In total, 126 patients were included in this analysis of which mean total costs were €29.830 per patient, consisting of €20.276 for primary salvage surgery along with admission and additionally €9.554 for re-interventions and re-admissions. In 61 (48%) patients, primary salvage surgery consisted of an intersphincteric resection of the anastomosis, while restorative salvage surgery was performed in the remaining patients. Patients were hospitalized in the general ward after primary salvage surgery for a mean of 8.9 days, with 0.7 days (mean) at the intensive care unit. Most performed re-interventions consisted of endoscopic vacuum sponge changes (n = 166), stoma closures (n = 59), and recurrent abscess drainages (n = 51).
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