Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer
Por:
Mafé J, Planelles B, Asensio S, Cerezal J, Inda MD, Lacueva F, Esteban MD, Martin C, Baschwitz B and Peiro, A
Publicada:
1 ago 2017
Categoría:
Pulmonary and respiratory medicine
Resumen:
Background: Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use.
Methods: A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed.
Results: One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63 +/- 9 years old, 57% males) or OPEN (n=75, 64%; age: 61 +/- 11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05).
Conclusions: The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile.
Filiaciones:
Mafé J:
Department of Thoracic Surgery, Department of Health of Alicante-General Hospital, Alicante, Spain
Planelles B:
Neuropharmacology on Pain (NED), Research Unit, Department of Health of Alicante-General Hospital, ISABIAL, Spain
Asensio S:
Department of Pneumology, Department of Health of Alicante-General Hospital, Alicante, Spain
Cerezal J:
Department of Thoracic Surgery, Department of Health of Alicante-General Hospital, Alicante, Spain
Inda MD:
Neuropharmacology on Pain (NED), Research Unit, Department of Health of Alicante-General Hospital, ISABIAL, Spain
Lacueva F:
Department of Thoracic Surgery, Department of Health of Alicante-General Hospital, Alicante, Spain
:
Operations Research Center, Miguel Hernandez University of Elche, Alicante, Spain
:
Department of Pneumology, Department of Health of Alicante-General Hospital, Alicante, Spain
Martin C:
Department of Pneumology, Department of Health of Alicante-General Hospital, Alicante, Spain
Baschwitz B:
Department of Thoracic Surgery, Department of Health of Alicante-General Hospital, Alicante, Spain
Peiro, A:
Neuropharmacology on Pain (NED), Research Unit, Department of Health of Alicante-General Hospital, ISABIAL, Spain
Clinical Pharmacology Unit, Department of Health of Alicante-General Hospital, Alicante, Spain
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