Pmd51 - Comparison of Costs and Outcomes Between Coblation Technology and Electrocautery Following Tonsillectomy and Adenoidectomy Procedures

Abstract

well as on the duration of use of anticoagulant and antiarrhythmic drugs and hospital stays. Carto Thermocool Smarttouch catheter; amiodarone, sotalol, propafenone; rivaroxaban, dabigatran and apixaban were the treatment approaches used for the cost analysis in this study. The cost analyses were made based on the perspective of the Social Security Institution in Turkey. RESULTS: The costs per AFib patient of drug therapy versus catheter ablation were as follows: antiarrhythmic drug (4.0088 TRY vs 112 TRY), function tests (1.194 TRY vs 0 TRY), physician visits (837 TRY vs 78 TRY), heart tests (4.918 TRY vs 683 TRY), anticoagulant drug (21.502 TRY vs 392 TRY), medical devices and procedures (0 TRY vs 14.615 TRY) and hospital stay (1.620 TRY vs 312 TRY). The number of threedimensional radio frequency catheter ablation procedures performed in Turkey in 2017 is 500. The total cost of AFib treatment for 500 patients was 17.079.30 TRY with drug therapy and 8.096.386 TRY with three-dimensional complex mapping catheter ablation. CONCLUSIONS: These results propose that catheter ablation requires less costly treatment than drug therapy for AFib patients in Turkey.

Tonsillectomy Outcomes for Coblation versus Bipolar Diathermy Techniques in Adult Patients: A Systematic Review and Meta-Analysis

“…A study conducted in the United Kingdom highlighted that coblation is a cost-effective intervention for tonsillectomy when compared with cold steel procedures for both adult and paediatric patients, with a probability of at least 0.7 at being cost-effective 26 . In another study conducted in the United States, coblation was reported to have significantly lower costs compared to electrocautery surgery, however, the total cost of coblation was slightly higher when central supply was taken into account 27 .…”

Tonsillectomy Outcomes for Coblation Versus Bipolar Diathermy Techniques in Adult Patients: A Systematic Review and Meta-Analysis

“…24 In another study conducted in the United States, coblation was reported to have significantly lower costs compared to electrocautery surgery; however, the total cost of coblation was slightly higher when central supply was taken into account. 25 Based upon the results from the best available evidence comparing coblation tonsillectomy to bipolar diathermy in adult patients, there is no significant difference in the outcomes between the 2 techniques apart from more rapid healing of the tonsillar fossae in the coblation technique. The current evidence, therefore, suggests coblation tonsillectomy does not necessarily need to replace bipolar diathermy in adult patients undergoing tonsillectomy.…”

“…24 In another study conducted in the United States, coblation was reported to have significantly lower costs compared to electrocautery surgery; however, the total cost of coblation was slightly higher when central supply was taken into account. 25…”

Coblation versus Bipolar Diathermy Hemostasis in Pediatric Tonsillectomy Patients: Systematic Review and Meta-Analysis

“…The study reported statistically significant lower costs for coblation compared to electrocautery surgery ($1,009 versus $1,162; P <0.0001) and pharmacy ($102.40 versus $117.20; P <0.0001) costs. However, when central supply is put into consideration the total cost of coblation is slightly higher 27 ($2,646 versus $2,591; P = 0.0011) with a difference of $55.94. However, because coblation is less likely to result in severe hemorrhage, it was found that using coblation tonsillectomy could save the National Health Service in the United Kingdom an incremental cost of £2000 for every avoided hemorrhage as opposed to using cold dissection with bipolar diathermy for haemostasis 28 .…”

“…A study in the United States included 7,562 patients under 12 years of age compared the costs of treatment and management of children undergoing tonsillectomy by either coblation or electrocautery technique 27 . The study reported statistically significant lower costs for coblation compared to electrocautery surgery ($1,009 versus $1,162; P <0.0001) and pharmacy ($102.40 versus $117.20; P <0.0001) costs.…”