Cost/efficacy evaluation of the technologies applied to video-assisted thoracoscopic surgery lobectomy

Abstract

Superior outcomes after video-assisted thoracoscopic surgery (VATS) pulmonary lobectomy have been demonstrated, compared with thoracotomy, for patients affected by early-stage non-small cell lung cancer (NSCLC). However, in an era of rising health care costs and controlled resources, the overall medical cost of surgical procedures is measured by the hospitals' marketing offices. Several factors such as surgical technique, conversion rate, length of stay, post-operative complications occurrence and mainly the introduction of new surgical technologies (disposables and devices) could influence the cost-effectiveness of VATS procedures. However, increased operating room costs are counteracted by shorter hospital stay and reduced ward bed stays providing further resources for other patients. Thus, choosing a surgical approach and assessing whether a specific technique is cost-effective is mandatory for a modern thoracic surgeon to justify its expenses. This review tries to reach a conclusion by comparing all recent studies reporting a cost analysis for VATS lobectomy, especially for new technologies used for VATS lobectomy. Nevertheless, no sufficient evidences are published to assess VATS new technologies sustainability and further cost analyses are necessary before VATS lobectomy expense is deemed justified.

A systematic review and meta-analysis of thoracoscopic versus thoracotomy sleeve lobectomy

“…Thoracoscopy has been widely adopted in the surgical management of lung cancer (6)(7)(8). Compared to conventional thoracotomy, favorable perioperative outcomes and uncompromising oncologic results could be achieved by this minimally invasive technique (9)(10)(11).…”

“…With the evolution of the minimally invasive technique, thoracoscopic surgery is extensively adopted in various pulmonary procedures (6)(7)(8). However, despite the advantages of thoracoscopic surgery in perioperative outcomes including shorter postoperative hospital stays, decreased chest drainage time and reduced postoperative complication rate (9)(10)(11), thoracotomy is still the preferred surgical approach in sleeve lobectomy considering the technical difficulty of thoracoscopic sleeve resection.…”

Internet of Things-Based Ultrasound-Guided Erector Spinae Plane Block Combined with Edaravone Anesthesia in Thoracoscopic Lobectomy

“…It plays an important supporting role in deepening the reform of the medical and health system, accelerating the construction of “healthy China,” and promoting the development of the medical and health industry [ 11 ]. At present, medical imaging such as ultrasound (scanning the human body with ultrasound beam and obtaining images of internal organs by receiving and processing reflected signals) and magnetic resonance have gradually developed from auxiliary examination methods into the most important clinical diagnosis and differential diagnosis methods in modern medicine [ 12 , 13 ]. Through big data plus artificial intelligence technology solutions, AI-assisted diagnosis and treatment adoptions are built, medical imaging data are modeled and analyzed, and conditions and lesions are analyzed to provide decision support for doctors and improve medical efficiency and quality [ 14 , 15 ].…”