[Replacement of tracheo-esophageal Provox prosthesis].
OBJECTIVE
To compare anesthesic techniques used between 1992 and 1997 at Laënnec Hospital for replacement by tracheo-esophageal Provox prosthesis: local and general anesthesia. Theoretical financial cost for replacement was estimated according to anaesthetic techniques.


METHODS
Provox in situ lifetime was calculated in 58 patients who underwent 115 and 49 replacements under general and local anaesthesia respectively. Age, sex, surgical and radiotherapy backgrounds, complications and anaesthetic techniques were studied as potential factors correlated with Provox in situ lifetime. Theoretical financial cost for replacement was estimated according to anaesthetic techniques.


RESULTS
In 1992, 12% of Provox prosthesis were inserted under local anaesthesia and 54% in 1997. Provox in situ lifetime was either not influenced by anaesthetic techniques or other factors under analysis. The theoretical financial cost was estimated at 14, 341 FFrs and 6,048 FFrs for replacement under general and local anaesthesia respectively.


CONCLUSIONS
Due to increased control of health care costs, we advocated local anaesthesia for Provox prosthesis replacement if control endoscopy is not required.
Biacabe
B
B
Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-faciale, Hôpital Laennec, Assistance Publique des Hôpitaux de Paris, UFR Necker Enfants Malades, Université Paris V, 42 rue de Sèvres 75007 Paris.
Laccourreye
O
O
Ménard
M
M
Hans
S
S
Brasnu
D
D
D000328:Adult; D000768:Anesthesia, General / Q000191:economics / Q000379:methods*; D000772:Anesthesia, Local / Q000191:economics / Q000379:methods*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007831:Larynx, Artificial; D008297:Male; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000191:economics; D012086:Reoperation / Q000191:economics; D013071:Speech, Alaryngeal; D014132:Trachea / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000175:diagnosis