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J Laryngol Otol ; 132(4): 341-348, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29248016

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.


Subject(s)
Cost-Benefit Analysis/methods , Electrosurgery/instrumentation , Oropharyngeal Neoplasms/economics , Oropharyngeal Neoplasms/surgery , Ultrasonic Therapy/instrumentation , Ultrasonics/instrumentation , Aged , Blood Loss, Surgical , Electrosurgery/adverse effects , Female , Hemostasis, Surgical/instrumentation , Humans , Male , Neoplasm Staging , Operative Time , Oropharyngeal Neoplasms/diagnosis , Surgical Instruments/statistics & numerical data , Ultrasonic Therapy/adverse effects
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