Key result
The use of an ultrasound scalpel during total thyroidectomy significantly improved quality of life at 3 months (0.91 vs 0.84, p=0.002) and reduced operation time compared to the traditional technique.
Why the study?
Does the ultrasound scalpel improve cost-effectiveness and quality of life compared to the traditional technique in patients undergoing total thyroidectomy?
RCT (n=198)
No
Does the ultrasound scalpel improve cost-effectiveness and quality of life compared to the traditional technique in patients undergoing total thyroidectomy?
Absolute Event Rate: 0.91% vs 0.84%
p-value: p=0.002
The use of an ultrasound scalpel in total thyroidectomy reduces operation time, improves quality of life, and provides cost savings compared to the traditional technique.
Ultrasound scalpel may lower thyroidectomy costs at one center; leaves open wider adoption pending multi-center confirmation.
BACKGROUND: Total thyroidectomy (TT) can be performed either with the traditional technique or using the ultrasound scalpel. Here, the use of the ultrasound scalpel is investigated in order to assess cost-effectiveness from an hospital, third party payer and societal perspective. METHODS: A randomized controlled trial was conducted at the University Hospital A. Gemelli in Rome. Data refer to 198 patients, randomized to either surgery with the ultrasound scalpel (n = 96) or traditional (n = 102) and followed for 3 months after hospital discharge. Operation time (OT) and resource consumption were recorded. Main clinical outcome investigated was quality of life (evaluated with EQ-5D). RESULTS: A shorter operation time (traditional: 76.36 vs ultrasound: 54.16 minutes, p < 0.001) was observed. 3 months after surgery, differences in QoL were significant (0.91 vs 0.84, p = 0.002). Concerning the hospital perspective, ultrasound scalpel allows savings of 119 EUR per patient. From a societal perspective, ultrasound scalpel is also related to lower medical resource consumption during a 3 month follow-up after discharge (traditional: 129.03 EUR vs ultrasound: 107.82 EUR) and lower non-medical resource utilization (transport/hotels costs traditional:535.51 EUR vs ultrasound: 342.77 EUR. No statistical difference was found in productivity losses up to 3 months (traditional: 377.71 EUR vs ultrasound: 385.51 EUR). CONCLUSION: Allowing an overall saving of 325.36 EUR per patient, Ultrasound scalpel should be adopted for TT procedures in the "A.Gemelli" University hospital.
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Ruggeri et al. (2012) conducted an RCT in Total thyroidectomy (n=198). Ultrasound scalpel vs. Traditional technique was evaluated on Quality of life (evaluated with EQ-5D) (p=0.002). The use of an ultrasound scalpel during total thyroidectomy significantly improved quality of life at 3 months (0.91 vs 0.84, p=0.002) and reduced operation time compared to the traditional technique.
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