The Hospital Center Florence Pietro Palagi, Florence, Italy.
Madre Fortunata Toniolo Clinic, Bologna, Italy.
J Minim Invasive Gynecol. 2018 Mar-Apr;25(3):418-425. doi: 10.1016/j.jmig.2017.08.001.
To compare the costs of hysteroscopic polypectomy using mechanical and electrosurgical systems in the hospital operating room and an office-based setting.
Retrospective cohort study (Canadian Task Force classification II-2).
Tertiary referral hospital and center for gynecologic care.
Seven hundred and fifty-four women who underwent endometrial polypectomy between January 20, 2015, and April 27, 2016.
Hysteroscopic endometrial polypectomy performed in the same-day hospital setting or office setting using one of the following: bipolar electrode, loop electrode, mechanical device, or hysteroscopic tissue removal system.
The various costs associated with the 2 clinical settings at Palagi Hospital, Florence, Italy were compiled, and a direct cost comparison was made using an activity-based cost-management system. The costs for using reusable loop electrode resection-16 or loop electrode resection-26 were significantly less expensive than using disposable loop electrode resection-27, the tissue removal system, or bipolar electrode resection (p = .0002). Total hospital costs for polypectomy with all systems were significantly less expensive in an office setting compared with same-day surgery in the hospital setting (p = .0001). Office-based hysteroscopic tissue removal was associated with shorter operative time compared with the other procedures (p = .0002) CONCLUSION: The total cost of hysteroscopic polypectomy is markedly higher when using disposable equipment compared with reusable equipment, both in the hospital operating room and the office setting. Same-day hospital or office-based surgery with reusable loop electrode resection is the most cost-effective approach in each settings, but requires experienced surgeons. Finally, the shorter surgical time should be taken into consideration for patients undergoing vaginal polypectomy in the office setting, owing more to patient comfort than to cost savings.
比较在医院手术室和基于办公室的环境中使用机械和电外科系统进行宫腔镜息肉切除术的成本。
回顾性队列研究（加拿大任务组分类 II-2）。
三级转诊医院和妇科护理中心。
2015 年 1 月 20 日至 2016 年 4 月 27 日期间行子宫内膜息肉切除术的 754 名女性。
在同一天的医院环境或办公室环境中，使用以下一种方法进行宫腔镜子宫内膜息肉切除术：双极电极、环电极、机械装置或宫腔镜组织切除系统。
在意大利佛罗伦萨的 Palagi 医院，编制了与这 2 种临床环境相关的各种成本，并使用基于活动的成本管理系统进行了直接成本比较。与使用一次性环电极切除术-27、组织切除系统或双极电极切除术相比，使用可重复使用的环电极切除术-16 或环电极切除术-26 的成本明显更低（p = .0002）。与在医院当天手术相比，所有系统进行息肉切除术的总医院成本在办公室环境中明显更低（p = .0001）。与其他手术相比，在办公室环境中使用宫腔镜组织切除术的手术时间更短（p = .0002）。
与可重复使用的设备相比，使用一次性设备进行宫腔镜息肉切除术的总成本在医院手术室和办公室环境中都明显更高。在每个环境中，使用可重复使用的环电极切除术的当天医院或办公室手术是最具成本效益的方法，但需要有经验的外科医生。最后，对于在办公室环境中接受阴道息肉切除术的患者，应考虑手术时间更短，这更多是出于患者舒适度，而不是节省成本。
