Faculty Collaboration Database

A cost-effective analysis of fibrin sealants versus no sealant following open right hemihepatectomy for colorectal liver metastases. ANZ J Surg 2017 Jun;87(6):E11-E14

Date

02/03/2015

Pubmed ID

25641546

DOI

10.1111/ans.12948

Scopus ID

2-s2.0-85020223623 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

BACKGROUND: There is paucity of data regarding the cost-effectiveness of fibrin sealants during liver surgery. This study aimed to assess the cost-effectiveness of fibrin sealants following right hemihepatectomy for colorectal liver metastases.

METHOD: A prospectively maintained database between 2004 and 2013 was reviewed to identify patients who underwent a right hemihepatectomy with and without fibrin sealant application. Perioperative and post-operative outcomes were analysed to assess its cost-effectiveness.

RESULTS: One hundred and sixty-three right hemihepatectomies were performed, of which 79 were in the fibrin sealant treatment group and 84 were in the no sealant group. No difference was seen between fibrin sealant and no sealant with regard to bile leak (P = 0.366), intra-abdominal collections (P = 0.200) and overall post-operative complications (P = 0.480). Operating costs were significantly cheaper in the no sealant group (P = 0.010). There was no difference seen in median post-operative stay between fibrin sealant versus no treatment (8 versus 9 days, P = 0.327), median total bed cost (£3900 versus £4300, P = 0.400), mean transfusion cost per patient (P = 0.201) and overall cost (£6706.15 versus £6555.80, P = 0.792).

CONCLUSION: Fibrin sealant application to cut surface during liver surgery confers no cost benefit and their routine use may not be recommended.

Author List

Pandanaboyana S, Bell R, Shah N, Lodge JPA, Hidalgo E, Toogood GJ, Prasad KR

Author

Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Blood Transfusion
Colorectal Neoplasms
Cost-Benefit Analysis
Female
Fibrin Tissue Adhesive
Hepatectomy
Humans
Length of Stay
Liver
Liver Neoplasms
Male
Middle Aged
Perioperative Period
Postoperative Complications
Postoperative Period
Prospective Studies