Tirelli G, Del Piero G C, Valentinuz G, Monte A, Gatto A, Rebelli A, Quatela E
ENT Department,Cattinara Hospital,University Clinical Department of Medical,Surgical and Health Sciences,University of Trieste,Italy.
Department of Economic, Business, Mathematical and Statistical Sciences 'Bruno de 'Finetti',University of Trieste,Italy.
J Laryngol Otol. 2018 Apr;132(4):341-348. doi: 10.1017/S0022215117002377. Epub 2017 Dec 18.
To evaluate the clinical efficacy and cost-effectiveness of ultrasonic shears and the electrothermal bipolar vessel sealing system, in comparison to the traditional cold knife and bipolar forceps, in oral and oropharyngeal cancer surgery.
Patients who underwent oral or oropharyngeal cancer resection and neck dissection with either ultrasonic shears (n = 36) or electrothermal bipolar vessel sealing (n = 32) were enrolled. Surgical time, intra-operative bleeding, blood drainage, post-operative pain, neck oedema, complications and hospitalisation duration were compared to those of an historical cohort of 36 patients treated using a cold knife and bipolar forceps. Additionally, a cost-effectiveness evaluation was performed.
Ultrasonic shears and, in particular, electrothermal bipolar vessel sealing, were advantageous compared to the traditional techniques. The cost of ultrasonic shears and electrothermal bipolar vessel sealing was completely offset by declining time-driven costs for the surgical team and operating theatre.
Ultrasonic shears and, in particular, electrothermal bipolar vessel sealing, are more advantageous compared to the traditional techniques, from both a clinical and economic point of view.
与传统冷刀和双极钳相比，评估超声刀和电热双极血管封闭系统在口腔和口咽癌手术中的临床疗效和成本效益。
纳入接受超声刀（n = 36）或电热双极血管封闭术（n = 32）进行口腔或口咽癌切除及颈部清扫的患者。将手术时间、术中出血、引流量、术后疼痛、颈部水肿、并发症及住院时间与36例使用冷刀和双极钳治疗的历史队列患者进行比较。此外，还进行了成本效益评估。
与传统技术相比，超声刀尤其是电热双极血管封闭术具有优势。超声刀和电热双极血管封闭术的成本因手术团队和手术室时间驱动成本的降低而完全抵消。
从临床和经济角度来看，超声刀尤其是电热双极血管封闭术比传统技术更具优势。
