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采用带有集成能量系统的新型手术剪进行腹腔镜根治性前列腺切除术患者的有效性和经济结果:一项基于中国一家三级医院数据库的回顾性研究。

Effectiveness and economic outcomes in patients undergoing laparoscopic radical prostatectomy with a new surgical shear with an integrated energy system: A retrospective study based on a tertiary hospital database in China.

作者信息

Gao Yi, Zhu Yu, Sun Fukang, Shao Yuan, Huang Tao, He Wei, Xie Xin, Chen Lu, Winberg Debra, Xu Danfeng

机构信息

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Tulane School of Public Health and Tropical Medicine, Department of Health Policy and Management, New Orleans, LA, USA.

出版信息

Asian J Urol. 2024 Oct;11(4):563-568. doi: 10.1016/j.ajur.2023.08.010. Epub 2024 May 7.

Abstract

OBJECTIVE

This study aimed to demonstrate a new surgical shear with an integrated energy system (Harmonic ACE®+7) value by determining its effectiveness and economic outcomes compared with conventional ultrasonic shears (CUSs) in a real-world setting.

METHODS

This was a retrospective study of adults with prostate cancer undergoing laparoscopic radical prostatectomy with the ACE®+7 shear or CUSs between August 2019 and April 2021 at Shanghai Ruijin Hospital (the headquarters and Luwan Center in China). Demographic and diagnosis information, intraoperative and postoperative clinical outcomes, and total and categorical costs were collected. Propensity score matching was performed to form the study population for each clinical group. Data were compared between the two groups using -test and Chi-squared test.

RESULTS

The ACE®+7 was associated with a lower mean number of hemostatic clips used per surgery compared with CUSs (12.8 19.8, <0.001), a moderate but not significant difference in mean postoperative drainage duration (6.6 [standard deviation, SD 2.2] days 7.9 [SD 4.1] days, =0.082), a reduction on mean total drainage volume (275.5 [SD 374.3 mL 492.9 [SD 1495.0] mL, =0.321), and a lower mean rate of postoperative hemostatic drug usage (16.0% 52.0%, <0.001). There was no significant difference in total costs between the ACE®+7 and CUS groups.

CONCLUSION

This study provides real-world data demonstrating that the ACE®+7 shear with an integrated energy system improves clinical outcomes compared with CUSs and can offer cost savings for hospitals and health systems. Using the ACE®+7 during laparoscopic radical prostatectomy allows physicians to help their patients achieve better outcomes and not spend additional money.

摘要

目的

本研究旨在通过在实际临床环境中比较新型集成能量系统手术剪(Harmonic ACE®+7)与传统超声手术剪(CUS)的有效性和经济结果,来评估该新型手术剪的价值。

方法

这是一项回顾性研究,研究对象为2019年8月至2021年4月期间在上海瑞金医院(中国总部及卢湾分院)接受腹腔镜根治性前列腺切除术的成年前列腺癌患者,手术中使用ACE®+7手术剪或CUS。收集患者的人口统计学和诊断信息、术中和术后临床结果以及总费用和分类费用。采用倾向得分匹配法为每个临床组形成研究人群。两组数据采用t检验和卡方检验进行比较。

结果

与CUS相比,ACE®+7手术剪每次手术平均使用的止血夹数量更少(12.8对19.8,P<0.001),术后平均引流持续时间有中度但无显著差异(6.6[标准差,SD 2.2]天对7.9[SD 4.1]天,P=0.082),平均总引流量减少(275.5[SD 374.3]mL对492.9[SD 1495.0]mL,P=0.321),术后止血药物平均使用率更低(16.0%对52.0%,P<0.001)。ACE®+7组和CUS组的总费用无显著差异。

结论

本研究提供了实际临床数据,表明集成能量系统的ACE®+7手术剪与CUS相比可改善临床结果,并可为医院和卫生系统节省成本。在腹腔镜根治性前列腺切除术中使用ACE®+7可使医生帮助患者获得更好的结果,且无需额外花费。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2839/11551345/6f66ed386e8e/gr1.jpg

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