2 524

Cited 0 times in

Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis

Authors
 Jennifer C. Cabot  ;  Cho Rok Lee  ;  Laurent Brunaud  ;  David A. Kleiman  ;  Woong Youn Chung  ;  Thomas J. Fahey III  ;  Rasa Zarnegar 
Citation
 SURGERY, Vol.152(6) : 1016-1024, 2012 
Journal Title
SURGERY
ISSN
 0039-6060 
Issue Date
2012
MeSH
Adult ; Axilla ; Carcinoma, Papillary/surgery ; Costs and Cost Analysis ; Endoscopy/economics* ; Female ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; Robotics/economics* ; Robotics/methods ; Thyroid Neoplasms/surgery ; Thyroidectomy/economics* ; Thyroidectomy/methods
Keywords
Adult ; Axilla ; Carcinoma, Papillary/surgery ; Costs and Cost Analysis ; Endoscopy/economics* ; Female ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; Robotics/economics* ; Robotics/methods ; Thyroid Neoplasms/surgery ; Thyroidectomy/economics* ; Thyroidectomy/methods
Abstract
BACKGROUND: This study presents a cost analysis of the standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy approaches based on medical costs in the United States.

METHODS: A retrospective review of 140 patients who underwent standard cervical, transaxillary endoscopic, or transaxillary robotic thyroidectomy at 2 tertiary centers was conducted. The cost model included operating room charges, anesthesia fee, consumables cost, equipment depreciation, and maintenance cost. Sensitivity analyses assessed individual cost variables.

RESULTS: The mean operative times for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were 121 ± 18.9, 185 ± 26.0, and 166 ± 29.4 minutes, respectively. The total cost for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were $9,028 ± $891, $12,505 ± $1,222, and $13,670 ± $1,384, respectively. Transaxillary approaches were significantly more expensive than the standard cervical technique (standard cervical/transaxillary endoscopic, P < .0001; standard cervical/transaxillary robotic, P < .0001; and transaxillary endoscopic/transaxillary robotic, P = .001). The transaxillary and standard cervical techniques became equivalent in cost when transaxillary endoscopic operative time decreased to 111 minutes and transaxillary robotic operative time decreased to 68 minutes. Increasing the case load did not resolve the cost difference.

CONCLUSION: Transaxillary endoscopic and transaxillary robotic thyroidectomies are significantly more expensive than the standard cervical approach. Decreasing operative times reduces this cost difference. The greater expense may be prohibitive in countries with a flat reimbursement schedule.
Full Text
http://www.sciencedirect.com/science/article/pii/S0039606012004825
DOI
23158175
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Chung, Woong Youn(정웅윤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91890
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links