Coloproctology Unit, Department of Surgery, Hospital Clinico Universitario, Zaragoza, Spain.
Surg Endosc. 2011 Oct;25(10):3209-13. doi: 10.1007/s00464-011-1695-0. Epub 2011 Apr 13.
An important fact when facing new technologies is their cost for the Health Publishes. The purpose of this paper is to compare the costs of performing TEM with harmonic scalpel and classic monopolar scalpel and to analyze complications.
Operation time, blood loss, and hospital stay were recorded to determine the cost of the TEM procedure. We also recorded early and late complications. Patients were divided in two groups: harmonic scalpel group (UC) and monopolar scalpel group (MS).
TEM for curative intention was used in 330 rectal tumors from January 1997 to January 2010. A total of 229 patients met the criteria for this study: UC group (n = 87) and MS group (n = 142). Patients from the UC group developed fewer complications (16%) than patients from the MS group (23%). The difference of mean stay between groups was 1.5 days (95% confidence interval, 0.7; 2.2 days; P < 0.001) in favor of the UC group.
Harmonic scalpel provides a safer, easier, and more precise surgical section through clean, bloodless, and better visualized operative field. The additional cost of UC was compensated with the decrease in the health resources (mainly hospital stay).
面对新技术时，一个重要的事实是它们对卫生部门的成本。本文旨在比较 TEM 与超声刀和传统单极电刀的操作成本，并分析并发症。
记录手术时间、失血量和住院时间，以确定 TEM 手术的成本。我们还记录了早期和晚期并发症。患者分为两组：超声刀组（UC）和单极电刀组（MS）。
1997 年 1 月至 2010 年 1 月，我们对 330 例直肠肿瘤患者进行了 TEM 治疗。共有 229 名患者符合本研究标准：UC 组（n = 87）和 MS 组（n = 142）。UC 组患者的并发症发生率（16%）低于 MS 组（23%）。两组间平均住院时间差异为 1.5 天（95%置信区间，0.7；2.2 天；P < 0.001），UC 组更具优势。
超声刀通过清洁、无血、可视化更好的手术视野，提供了更安全、更容易、更精确的手术切割。UC 的额外成本通过减少卫生资源（主要是住院时间）得到了补偿。
