{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:01:06Z","timestamp":1766052066892,"version":"3.48.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Styker European Operations B.V."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limited data exist on hospital costs incurred by anastomotic leakage (AL), particularly in relation to specific treatment approaches. This study aimed to analyse the incremental hospital costs of AL after total mesorectal excision (TME), stratified by treatment strategy, over a 1-year time horizon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing total mesorectal excision (TME) for rectal cancer (2020\u20132023), included in the control cohort of the IMARI-study at 15 Dutch centres, were analysed. A cost analysis was conducted according to Dutch National Healthcare Institute guidelines. The primary outcome was the incremental hospital costs incurred by patients with AL detected within 30\u00a0days postoperatively, stratified by treatment strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis compared treatment costs in 32 patients with AL and 82 patients without AL. The average hospital costs per patient in the first postoperative year were \u20ac15.312. In patients with AL, the mean incremental costs were \u20ac24.333. Major cost drivers in the AL group were prolonged hospitalization (+\u20ac13.150) and (re)interventions (+\u20ac8.910). The treatment costs differed significantly between strategies: no faecal diversion (\u20ac10.062), faecal diversion with passive drainage (\u20ac23.903), faecal diversion with active drainage (\u20ac35.552), and salvage surgery (\u20ac38.793).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AL after TME resulted in a nearly fourfold increase in hospital costs compared with patients without AL. Salvage surgery was the most expensive treatment strategy, followed by faecal diversion with active drainage. Future studies should evaluate how these treatment costs relate to clinical success rates, including rates of chronic pelvic sepsis and permanent stomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      This study used data from the IMARI-study. The IMARI-study is registered with the Dutch Central Committee on Research Involving Human Subjects (NL67600.018.18) and is submitted to the\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.onderzoekmetmensen.nl\/en\" ext-link-type=\"uri\">http:\/\/www.onderzoekmetmensen.nl\/en<\/jats:ext-link>\n                      database (NL-OMON26456 and NL-OMON55903).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-025-03215-2","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T13:33:53Z","timestamp":1759930433000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hospital costs of different treatment strategies for anastomotic leakage after total mesorectal excision: a multicentre cost analysis"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8360-8585","authenticated-orcid":false,"given":"D. 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M.J.P. reports grants and honoraria from various pharmaceutical companies, all unrelated to this research, and is an advisor of Asc Academics and holds stocks from Health-Ecore and Pharmacoeconomics Advice Groningen. W.A.B. has received grants from Braun and Vifor, and has served as speaker for Takeda, Johnson and Johnson and Braun. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors declare no other conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study analysed data from the IMARI-study. The IMARI-study has been approved by the Medical Ethical Committee (METC 2019_055, August 14th, 2019) and Biobank committee (METC 2019_219, February 21st, 2020) of the Amsterdam UMC, location AMC. The protocol is registered by the Dutch Central Committee on Research Involving Human Subjects (NL67600.018.18).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}},{"value":"Written informed consent was obtained from all participants.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent statements"}}],"article-number":"173"}}