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J Laryngol Otol ; 132(4): 341-348, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29248016

RESUMO

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.


Assuntos
Análise Custo-Benefício/métodos , Eletrocirurgia/instrumentação , Neoplasias Orofaríngeas/economia , Neoplasias Orofaríngeas/cirurgia , Terapia por Ultrassom/instrumentação , Ultrassom/instrumentação , Idoso , Perda Sanguínea Cirúrgica , Eletrocirurgia/efeitos adversos , Feminino , Hemostasia Cirúrgica/instrumentação , Humanos , Masculino , Estadiamento de Neoplasias , Duração da Cirurgia , Neoplasias Orofaríngeas/diagnóstico , Instrumentos Cirúrgicos/estatística & dados numéricos , Terapia por Ultrassom/efeitos adversos
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