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儿童扁桃体切除术:三种技术的五因素分析——报告临床结果、麻醉时间、手术时间、出血和成本。

Tonsillectomy in children: a five-factor analysis among three techniques--reporting upon clinical results, anesthesia time, surgery time, bleeding, and cost.

机构信息

Division of Pediatric Otolaryngology, Department of Otorhinolaryngology, Vicenza Civil Hospital, Vicenza, Italy.

出版信息

Laryngoscope. 2010 Dec;120(12):2502-7. doi: 10.1002/lary.21128.

Abstract

OBJECTIVES

Improved technology claims better clinical results for adenotonsillectomy (T&A) in children, and promoters of each technique announce many virtues over one another, year after year. However, cost remains one variable that is not always thoroughly addressed. In this study, monopolar cautery (MPC) T&A was compared with coblation (CAT) and molecular resonance (MR) techniques in a pediatric population.

STUDY DESIGN

Prospective analysis of 96 patients (32 for each surgical modality: MPC, MR, or CAT).

SETTING

Tertiary care pediatric institution.

SUBJECTS AND METHODS

Clinical results, anesthesia and surgery time, bleeding, and cost among these three established techniques were compared. P-values of P < .05 were considered significant for all comparisons.

RESULTS

The CAT and MPC had similar operative times (mean 19.2 and 21.1 minutes, respectively, P = NS), whereas the MR group had overall saving of 7.8 minutes in surgery (P < .05). In terms of cost of technology, the cost of the MPC and MR groups was 90.6% and 83.7% less than the CAT group, respectively.

CONCLUSIONS

This study demonstrated that MR technique of T&A enabled the surgical team to save a significant amount of time, whereas CAT added substantial costs, compared to MR and standard cautery techniques.

摘要

目的

改进的技术声称对儿童腺样体扁桃体切除术(T&A)有更好的临床效果,并且每种技术的推广者每年都在相互宣布许多优点。然而,成本仍然是一个未被充分考虑的变量。在这项研究中,我们比较了单极电凝(MPC)T&A 与等离子(CAT)和分子共振(MR)技术在儿科人群中的效果。

研究设计

对 96 例患者(每例手术方式 32 例:MPC、MR 或 CAT)进行前瞻性分析。

研究地点

三级儿童医疗机构。

研究对象及方法

比较这三种成熟技术的临床效果、麻醉和手术时间、出血情况和成本。所有比较的 P 值均 <.05 认为有统计学意义。

结果

CAT 和 MPC 的手术时间相似(平均分别为 19.2 分钟和 21.1 分钟,P = NS),而 MR 组的手术时间总体节省了 7.8 分钟(P <.05)。在技术成本方面,MPC 和 MR 组的成本分别比 CAT 组低 90.6%和 83.7%。

结论

这项研究表明,与标准电凝技术相比,MR 技术的 T&A 使手术团队能够节省大量时间,而 CAT 则增加了大量成本。

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