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2017 ; 9
(ä): 201-206
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Cost analysis of pulmonary lobectomy procedure: comparison of stapler versus
precision dissection and sealant
#MMPMID28408847
Droghetti A
; Marulli G
; Vannucci J
; Giovanardi M
; Bottoli MC
; Ragusa M
; Muriana G
Clinicoecon Outcomes Res
2017[]; 9
(ä): 201-206
PMID28408847
show ga
OBJECTIVE: We aimed to evaluate the direct costs of pulmonary lobectomy
hospitalization, comparing surgical techniques for the division of interlobar
fissures: stapler (ST) versus electrocautery and hemostatic sealant patch (ES).
METHODS: The cost comparison analysis was based on the clinical pathway and drawn
up by collecting the information available from the Thoracic Surgery Division
medical team at Mantova Hospital. Direct resource consumption was derived from a
previous randomized controlled trial including 40 patients. Use and maintenance
of technology, equipment and operating room; administrative plus general costs;
and 30-day use of postsurgery hospital resources were considered. The analysis
was conducted from the hospital perspective. RESULTS: On the average, a patient
submitted to pulmonary lobectomy costs ?9,744.29. This sum could vary from ?9,027
(using ES) to ?10,460 (using ST). The overall lower incidence (50% vs 95%,
P=0.0001) and duration of air leakage (1.7 days vs 4.5 days, P=0.0001) in the ES
group significantly affects the mean time of hospital stay (11.0 days vs 14.3
days) and costs. Cost saving in the ES group was also driven by the lower
incidence of complications. The main key cost driver was staff employment (42%),
then consumables (34%) and operating room costs (12%). CONCLUSION: There is an
overall saving of around ?1,432.90 when using ES patch for each pulmonary
lobectomy. Among patients undergoing this surgical procedure, ES can
significantly reduce air leakage incidence and duration, as well as decrease
hospitalization rates. However, further multicenter research should be developed
considering different clinical and managerial settings.
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