PCN83 - Virtual Planning and Patient-Specific Implants in Mandibular Reconstructionsurgery: A Micro-Costing Analysiss

Abstract

Mandibular reconstruction surgery is a routine procedure managed with bone containing free flaps, being fibula and iliac crest the most used worldwide. Despite these surgical techniques are well established and strengthen, the adoption of a 3D virtual planning and customized implants, including pre-operative planning, surgical hardware and patient-customized implants, guarantees optimal functional and cosmetic outcomes compared with traditional technique. The objective of this study is to determine and compare the resource consumption associated with 3D virtual planning and customized implants compared to traditional technique in patients undergoing mandibular reconstruction surgery. The economic study was performed through a micro-costing approach from hospital perspective in an experienced Italian Hospital, where data on 34 cases of mandibular reconstruction surgery (13 performed by 3D virtual surgical planning and 21 performed by traditional technique) were collected retrospectively from hospital database. The consumption of resources was extracted for each patient according to phases of the hospital procedure including hospital and intensive care unit length of stay, diagnostic tests, staff time, operating theatre occupation time and medical technology equipment utilization. Unit costs were provided by the Administrations and Management Control Offices and statistical analysis was carried out using appropriate techniques. Results confirmed that 3D virtual planning and customized implants led to reduce operating theatre time (9.33 hours versus 10.96 hours; p<0.05) e hospital length of stay (11.23 days versus 24.00 days; p<0.0001). As consequence, the average hospitalization cost per patient associated with 3D virtual surgical planning was lower than a traditional technique (€ 20,342.27 versus € 26,163.02; p<0.01) showing an average cost savings of € 5,820.76 for patient. The analysis showed that the 3D virtual planning and customized implants, including pre-operative planning, surgical hardware and patient-customized implants, has a lower economic impact than traditional technique, guaranteeing optimal clinical outcomes and constituting the best option in mandibular reconstruction.