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Intraoperative costs of video-assisted thoracoscopic lobectomy can be dramatically reduced without compromising outcomes
- Source :
- The Journal of thoracic and cardiovascular surgery. 155(3)
- Publication Year :
- 2017
-
Abstract
- To determine whether surgeon selection of instrumentation and other supplies during video-assisted thoracoscopic lobectomy (VATSL) can safely reduce intraoperative costs.In this retrospective, cost-focused review of all video-assisted thoracoscopic surgery anatomic lung resections performed by 2 surgeons at a single institution between 2010 and 2014, we compared VATSL hospital costs and perioperative outcomes between the surgeons, as well as costs of VATSL compared with thoracotomy lobectomy (THORL).A total of 100 VATSLs were performed by surgeon A, and 70 were performed by surgeon B. The preoperative risk factors did not differ significantly between the 2 groups of surgeries. Mean VATSL total hospital costs per case were 24% percent greater for surgeon A compared with surgeon B (P = .0026). Intraoperative supply costs accounted for most of this cost difference and were 85% greater for surgeon A compared with surgeon B (P .0001). The use of nonstapler supplies, including energy devices, sealants, and disposables, drove intraoperative costs, accounting for 55% of the difference in intraoperative supply costs between the surgeons. Operative time was 25% longer for surgeon A compared with surgeon B (P .0001), but this accounted for only 11% of the difference in total cost. Surgeon A's overall VATSL costs per case were similar to those of THORLs (n = 100) performed over the same time period, whereas surgeon B's VATSL costs per case were 24% less than those of THORLs. On adjusted analysis, there was no difference in VATSL perioperative outcomes between the 2 surgeons.The costs of VATSL differ substantially among surgeons and are heavily influenced by the use of disposable equipment/devices. Surgeons can substantially reduce the costs of VATSL to far lower than those of THORL without compromising surgical outcomes through prudent use of costly instruments and technologies.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Lung Neoplasms
Time Factors
Cost effectiveness
Lung resections
medicine.medical_treatment
Cost-Benefit Analysis
Preoperative risk
Operative Time
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Cost Savings
Equipment Reuse
Medicine
Humans
Video assisted
Thoracotomy
Hospital Costs
Disposable Equipment
Pneumonectomy
health care economics and organizations
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Thoracic Surgery, Video-Assisted
Perioperative
Middle Aged
Surgical Instruments
Surgery
surgical procedures, operative
Outcome and Process Assessment, Health Care
Treatment Outcome
030228 respiratory system
Cardiothoracic surgery
Female
Cardiology and Cardiovascular Medicine
business
Wedge resection (lung)
Subjects
Details
- ISSN :
- 1097685X
- Volume :
- 155
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Accession number :
- edsair.doi.dedup.....96e6980ee663c16dbf3191ed3ba4308f