Premium
A cost‐effective analysis of fibrin sealants versus no sealant following open right hemihepatectomy for colorectal liver metastases
Author(s) -
Pandanaboyana Sanjay,
Bell Richard,
Shah Nehal,
Lodge J. Peter A.,
Hidalgo Ernest,
Toogood Giles J.,
Prasad K. Raj
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12948
Subject(s) - sealant , medicine , fibrin , surgery , perioperative , fibrin tissue adhesive , significant difference , cost effectiveness , abdominal surgery , chemistry , risk analysis (engineering) , organic chemistry , immunology
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.