Abstract:
STUDY OBJECTIVE:To evaluate the cost effectiveness of the Nd-YAG laser and bronchoscopic electrocautery for palliation in patients with symptomatic tumor obstruction. DESIGN:A retrospective study. SETTING:Bronchoscopy unit of a university hospital. PATIENTS AND INTERVENTION:Thirty-one consecutive patients with inoperable non-small cell lung cancer and symptomatic intraluminal tumor underwent bronchoscopic treatment. Dyspnea relief was the primary goal of treatment. Fourteen patients were treated with the Nd-YAG laser and 17 patients with electrocautery. MEASUREMENTS AND RESULTS:Improvement of symptoms was achieved in 70% of patients treated by either Nd-YAG laser or electrocautery. Mean +/- SD survival was 8.0 +/- 2.5 months after Nd-YAG laser treatment and 11.5 +/- 3.5 months after electrocautery. The number of treatment sessions per patient was comparable: Nd-YAG laser, 1.1; electrocautery, 1.2. Duration of hospital stay was longer in patients treated with the Nd-YAG laser (8.4 vs 6.7 days). Average treatment costs, including admission charges, were $5,321 for the Nd-YAG laser and $4,290 for electrocautery. Higher costs in the group treated with the Nd-YAG laser were caused by a longer hospital stay before bronchoscopic treatment. Costs of equipment (electrocautery $6,701 and Nd-YAG laser $208,333), write-offs, maintenance, and repair were not included in this calculation. CONCLUSION:Bronchoscopic electrocautery is equally effective but is a less expensive and, in our hospital, a more accessible modality than the Nd-YAG laser for symptomatic palliation of patients with intraluminal airway obstruction.
journal_name
Chestjournal_title
Chestauthors
Boxem Tv,Muller M,Venmans B,Postmus P,Sutedja Tdoi
10.1378/chest.116.4.1108subject
Has Abstractpub_date
1999-10-01 00:00:00pages
1108-12issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)37166-Xjournal_volume
116pub_type
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