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Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)

BACKGROUND: The benefits of single‐use ultrasonic scissors in thyroid surgery are still debated. Although this device has been shown to reduce operating time compared with conventional haemostasis, its cost‐effectiveness has never been demonstrated. The aim of this study was to evaluate the efficacy...

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Autores principales: Blanchard, C., Pattou, F., Brunaud, L., Hamy, A., Dahan, M., Mathonnet, M., Volteau, C., Caillard, C., Durand‐Zaleski, I., Mirallié, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989994/
https://www.ncbi.nlm.nih.gov/pubmed/29951599
http://dx.doi.org/10.1002/bjs5.2
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author Blanchard, C.
Pattou, F.
Brunaud, L.
Hamy, A.
Dahan, M.
Mathonnet, M.
Volteau, C.
Caillard, C.
Durand‐Zaleski, I.
Mirallié, E.
author_facet Blanchard, C.
Pattou, F.
Brunaud, L.
Hamy, A.
Dahan, M.
Mathonnet, M.
Volteau, C.
Caillard, C.
Durand‐Zaleski, I.
Mirallié, E.
author_sort Blanchard, C.
collection PubMed
description BACKGROUND: The benefits of single‐use ultrasonic scissors in thyroid surgery are still debated. Although this device has been shown to reduce operating time compared with conventional haemostasis, its cost‐effectiveness has never been demonstrated. The aim of this study was to evaluate the efficacy, cost‐effectiveness and safety of ultrasonic scissors for total thyroidectomy. METHODS: This was a prospective, randomized, multicentre trial conducted at 13 hospital sites. The primary endpoint was the percentage of patients with hypocalcaemia (serum calcium level below 2 mmol/l) on day 2. Secondary endpoints included postoperative complications and costs, with calculation of incremental cost differences and cost‐effectiveness ratios. RESULTS: In total, 1329 patients who underwent total thyroidectomy were included in the analysis: 670 were randomized to treatment with ultrasonic scissors and 659 to conventional haemostasis. There was no difference between groups in the rate of complications, including hypocalcaemia on day 2 (19(.)7 per cent in ultrasonic scissors group versus 20(.)3 per cent in conventional haemostasis group; P = 0·743). Median operating times were significantly shorter with ultrasonic scissors (90 versus 100 min with conventional haemostasis; P < 0·001). Total mean(s.d.) direct costs at 6 months were €4311(1547) and €4011(1596) respectively (P < 0·001). CONCLUSION: Ultrasonic scissors were no more clinically effective than conventional haemostasis, but use of these devices was more costly. Registration number: NCT01551914 (http://www.clinicaltrials.gov).
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spelling pubmed-59899942018-06-27 Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr) Blanchard, C. Pattou, F. Brunaud, L. Hamy, A. Dahan, M. Mathonnet, M. Volteau, C. Caillard, C. Durand‐Zaleski, I. Mirallié, E. BJS Open Randomized Clinical Trial BACKGROUND: The benefits of single‐use ultrasonic scissors in thyroid surgery are still debated. Although this device has been shown to reduce operating time compared with conventional haemostasis, its cost‐effectiveness has never been demonstrated. The aim of this study was to evaluate the efficacy, cost‐effectiveness and safety of ultrasonic scissors for total thyroidectomy. METHODS: This was a prospective, randomized, multicentre trial conducted at 13 hospital sites. The primary endpoint was the percentage of patients with hypocalcaemia (serum calcium level below 2 mmol/l) on day 2. Secondary endpoints included postoperative complications and costs, with calculation of incremental cost differences and cost‐effectiveness ratios. RESULTS: In total, 1329 patients who underwent total thyroidectomy were included in the analysis: 670 were randomized to treatment with ultrasonic scissors and 659 to conventional haemostasis. There was no difference between groups in the rate of complications, including hypocalcaemia on day 2 (19(.)7 per cent in ultrasonic scissors group versus 20(.)3 per cent in conventional haemostasis group; P = 0·743). Median operating times were significantly shorter with ultrasonic scissors (90 versus 100 min with conventional haemostasis; P < 0·001). Total mean(s.d.) direct costs at 6 months were €4311(1547) and €4011(1596) respectively (P < 0·001). CONCLUSION: Ultrasonic scissors were no more clinically effective than conventional haemostasis, but use of these devices was more costly. Registration number: NCT01551914 (http://www.clinicaltrials.gov). John Wiley & Sons, Ltd 2017-05-09 /pmc/articles/PMC5989994/ /pubmed/29951599 http://dx.doi.org/10.1002/bjs5.2 Text en © 2017 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Randomized Clinical Trial
Blanchard, C.
Pattou, F.
Brunaud, L.
Hamy, A.
Dahan, M.
Mathonnet, M.
Volteau, C.
Caillard, C.
Durand‐Zaleski, I.
Mirallié, E.
Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)
title Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)
title_full Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)
title_fullStr Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)
title_full_unstemmed Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)
title_short Randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (FOThyr)
title_sort randomized clinical trial of ultrasonic scissors versus conventional haemostasis to compare complications and economics after total thyroidectomy (fothyr)
topic Randomized Clinical Trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989994/
https://www.ncbi.nlm.nih.gov/pubmed/29951599
http://dx.doi.org/10.1002/bjs5.2
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