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New generation cut-and-seal devices in oral and oropharyngeal cancer resection: clinical and cost-effectiveness study

Published online by Cambridge University Press:  18 December 2017

G Tirelli ,
G C Del Piero ,
G Valentinuz ,
A Monte ,
A Gatto ,
A Rebelli  and
E Quatela
G Tirelli
Affiliation:
ENT Department, Cattinara Hospital, University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
G C Del Piero
Affiliation:
ENT Department, Cattinara Hospital, University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
G Valentinuz
Affiliation:
Department of Economic, Business, Mathematical and Statistical Sciences ‘Bruno de ‘Finetti’, University of Trieste, Italy
A Monte
Affiliation:
Department of Economic, Business, Mathematical and Statistical Sciences ‘Bruno de ‘Finetti’, University of Trieste, Italy
A Gatto
Affiliation:
ENT Department, Cattinara Hospital, University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
A Rebelli
Affiliation:
University Medical Center ‘Ospedali Riuniti’ of Trieste, Italy
E Quatela*
Affiliation:
ENT Department, Cattinara Hospital, University Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
*
Address for correspondence: Dr Eliana Quatela, ENT Department, Cattinara Hospital, Strada di Fiume, 447, 34149 Trieste, Italy Fax: 00 39 0403 994 180 E-mail: quatela.eliana@gmail.com
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Abstract

Objectives:

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.

Methods:

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.

Results:

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.

Conclusion:

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.

Keywords

UltrasonicsOperative TimeCost-Benefit AnalysisSurgical InstrumentsHead And Neck Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 4 , April 2018 , pp. 341 - 348
Copyright
Copyright © JLO (1984) Limited 2017 

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