Abstract
BackgroundTo assess the economic impact of powered stapler use in video-assisted thoracic surgery (VATS) lobectomy for lung cancer in a Chinese tertiary care hospital.MethodsThis study identified 388 patients who received VATS lobectomy using the ECHELON powered stapler (n = 296) or the ECHELON manual stapler (n = 92) for lung cancer in a Chinese tertiary hospital. Multiple generalized linear regression analyses were conducted using data on hospital costs and patient characteristics to develop predictive equations for hospital costs in a cost-minimization analysis (CMA) model comparing hospital costs associated with the ECHELON powered stapler and the ECHELON manual stapler. CMA model was used to conduct scenario analysis to compare the ECHELON powered stapler with another manual stapler (Victor Medical).ResultsThe multiple generalized linear regression analyses identified that using the ECHELON powered stapler in VATS lobectomy for lung cancer was associated with significantly lower drug costs than using the ECHELON manual stapler (coefficient − 0.256, 95% confidence interval: − 0.375 to − 0.139). The CMA model estimated that the ECHELON powered stapler could save hospital costs by ¥1653 when compared with the ECHELON manual stapler (¥65,531 vs. ¥67,184). The use of the ECHELON powered stapler also saved hospital costs by ¥4411 when compared with the Victor Medical manual stapler (¥65,531 vs. ¥69,942) in the scenario analysis.ConclusionsCompared to the two manual staplers used for VATS lobectomy for lung cancer in a Chinese tertiary hospital, the ECHELON powered stapler had 100% probability to save total hospital costs under present prices of the three staplers according to the CMA.
Highlights
With its genesis as a “mechanical stitching device” in 1908, the stapler evolved from the “Fischer-Hültl stapler”, which weighed 5 kg and took 2 h to assemble, to theCao et al Health Economics Review (2022) 12:12 in pulmonary resection through video-assisted thoracic surgery (VATS), which lacks sufficient surgery space to perform endoscopic suturing [3].The uneven force distribution inherent in manual stapler operation often causes instability of its distal tip and increases the risk of oozing or bleeding along the staple line
To further add meaningful evidence to the topic, this study employs the cost-minimization analysis (CMA) method to explore the potential economic benefits associated with using powered stapler in VATS lobectomy for lung cancer
To further compare the two types of staplers, this study uses CMA to assess the economic impact of utilizing a powered stapler in VATS lobectomy for lung cancer in a Chinese tertiary hospital
Summary
With its genesis as a “mechanical stitching device” in 1908, the stapler evolved from the “Fischer-Hültl stapler”, which weighed 5 kg and took 2 h to assemble, to theCao et al Health Economics Review (2022) 12:12 in pulmonary resection through video-assisted thoracic surgery (VATS), which lacks sufficient surgery space to perform endoscopic suturing [3].The uneven force distribution inherent in manual stapler operation often causes instability of its distal tip and increases the risk of oozing or bleeding along the staple line. There is dissonance among existing literature on the clinical and economic benefits associated with the use of a powered stapler in VATS lobectomy. Four real-world studies from the United States, South Korea, and Japan reported that the use of a powered stapler was associated with significantly lower risk of complications (i.e., bleeding and pleurodesis) and lower hospital costs than the use of a manual powered stapler in VATS lobectomy [4–7]. To further add meaningful evidence to the topic, this study employs the cost-minimization analysis (CMA) method to explore the potential economic benefits associated with using powered stapler in VATS lobectomy for lung cancer. To assess the economic impact of powered stapler use in video-assisted thoracic surgery (VATS) lobectomy for lung cancer in a Chinese tertiary care hospital
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