Università Cattolica del Sacro Cuore, Rome, Italy.
Int J Technol Assess Health Care. 2012 Jul;28(3):259-64. doi: 10.1017/S0266462312000220.
Total thyroidectomy (TT) can be performed either with the traditional technique or using the ultrasound scalpel. Here, the use of the ultrasound scalpel is investigated in order to assess cost-effectiveness from an hospital, third party payer and societal perspective.
A randomized controlled trial was conducted at the University Hospital A. Gemelli in Rome. Data refer to 198 patients, randomized to either surgery with the ultrasound scalpel (n = 96) or traditional (n = 102) and followed for 3 months after hospital discharge. Operation time (OT) and resource consumption were recorded. Main clinical outcome investigated was quality of life (evaluated with EQ-5D).
A shorter operation time (traditional: 76.36 vs ultrasound: 54.16 minutes, p < 0.001) was observed. 3 months after surgery, differences in QoL were significant (0.91 vs 0.84, p = 0.002). Concerning the hospital perspective, ultrasound scalpel allows savings of 119 EUR per patient. From a societal perspective, ultrasound scalpel is also related to lower medical resource consumption during a 3 month follow-up after discharge (traditional: 129.03 EUR vs ultrasound: 107.82 EUR) and lower non-medical resource utilization (transport/hotels costs traditional:535.51 EUR vs ultrasound: 342.77 EUR. No statistical difference was found in productivity losses up to 3 months (traditional: 377.71 EUR vs ultrasound: 385.51 EUR).
Allowing an overall saving of 325.36 EUR per patient, Ultrasound scalpel should be adopted for TT procedures in the "A.Gemelli" University hospital.
全甲状腺切除术（TT）可采用传统技术或超声刀进行。在此，从医院、第三方付款人和社会角度评估了超声刀的使用是否具有成本效益。
该研究在罗马 A. Gemelli 大学医院进行了一项随机对照试验。数据涉及 198 名患者，随机分为超声刀组（n=96）或传统组（n=102），并在出院后 3 个月进行随访。记录手术时间（OT）和资源消耗。主要临床结局是生活质量（用 EQ-5D 评估）。
观察到手术时间更短（传统：76.36 分钟 vs 超声：54.16 分钟，p<0.001）。术后 3 个月，QoL 差异显著（0.91 对 0.84，p=0.002）。从医院角度来看，超声刀可使每位患者节省 119 欧元。从社会角度来看，超声刀还与出院后 3 个月随访期间医疗资源消耗降低有关（传统：129.03 欧元 vs 超声：107.82 欧元），非医疗资源利用减少（交通/酒店费用传统：535.51 欧元 vs 超声：342.77 欧元）。在 3 个月内的生产力损失方面未发现统计学差异（传统：377.71 欧元 vs 超声：385.51 欧元）。
超声刀可使每位患者总体节省 325.36 欧元，应在“AGemelli”大学医院采用超声刀进行 TT 手术。
