Department of Otolaryngology–Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario.
J Otolaryngol Head Neck Surg. 2011 Feb;40(1):48-53.
To determine whether simultaneous (ablation and reconstruction overlaps by two teams) head and neck reconstruction is cost effective compared to sequentially (ablation followed by reconstruction) performed surgery.
Case-controlled study.
Tertiary care hospital.
Oncology patients undergoing free flap reconstruction of the head and neck.
A match paired comparison study was performed with a retrospective chart review examining the total time of surgery for sequential and simultaneous surgery. Nine patients were selected for both the sequential and simultaneous groups. Sequential head and neck reconstruction patients were pair matched with patients who had undergone similar oncologic ablative or reconstructive procedures performed in a simultaneous fashion. A detailed cost analysis using the microcosting method was then undertaken looking at the direct costs of the surgeons, anesthesiologist, operating room, and nursing.
On average, simultaneous surgery required 3 hours 15 minutes less operating time, leading to a cost savings of approximately $1200/case when compared to sequential surgery. This represents approximately a 15% reduction in the cost of the entire operation.
Simultaneous head and neck reconstruction is more cost effective when compared to sequential surgery.
比较头颈部重建的同期（两个团队同时进行消融和重建）与序贯（先消融后重建）手术，以确定前者是否具有成本效益。
病例对照研究。
三级护理医院。
接受游离皮瓣头颈部重建的肿瘤患者。
采用回顾性图表审查进行配对比较研究，检查序贯和同期手术的总手术时间。为序贯和同期两组各选择了 9 名患者。将同期头颈部重建患者与以同期方式进行类似肿瘤消融或重建手术的患者进行配对。然后使用微观成本法进行详细的成本分析，考察外科医生、麻醉师、手术室和护士的直接成本。
同期手术平均减少了 3 小时 15 分钟的手术时间，与序贯手术相比，每例可节省约 1200 美元。这代表整个手术成本降低了约 15%。
与序贯手术相比，同期头颈部重建更具成本效益。
