title: [Cost effectiveness of Ligasure Precise versus surgical clips during axillary nodal dissection for breast cancer].
abstract: Introduction. The techniques used for axillary node dissection are constantly evolving. The advent of the grip Ligasure Precise raise the question of its cost-effectiveness compared with surgical clips.
  
  
  OBJECTIVE
  To compare the effectiveness of Ligasure compared with surgical clips for simple axillary node dissection or Patey procedure in terms of duration of drainage, cost of hospitalization and complications.
  
  
  METHODS
  and method. Retrospective study extending from January 1, 2003 to December 31, 2004, concerning 187 patients who underwent simple axillary dissection (100) or Patey procedure (87), with use of surgical clips or Ligasure followed by drainage.
  
  
  RESULTS
  The use of Ligasure increased the operative cost because its price is higher than that of a clip grip with a refill. Ligasure significantly decreased the duration of drainage in the two groups but there was significantly more abundant fluid loss in the dissection group. The cost of hospitalization related to the choice of the technique of hemostasis (cost of the material + lasted of drainage X price of the day of hospitalization), was not significantly favor of Ligasure. Taking into account the choice of the hemostasis technique and the total duration of hospitalization (material cost + duration of hospitalization X price of the day of hospitalization), there is no significant difference between the two groups.
  
  
  CONCLUSIONS
  This study compares grip Ligasure Precise with surgical clips for axillary dissection. The duration of drainage was significantly shorter with Ligasure Precise but its benefit in terms of fluid loss remains to be shown. The use of Ligasure does not significantly reduce the cost of hospitalization.
authors.affiliation: Service de Gynécologie-Obstétrique, CHU de Besançon, Hôpital Saint-Jacques, 2, place Saint-Jacques, 25030 Besançon Cedex.
authors.forename: K
authors.initials: K
authors.lastname: Magri
authors.forename: V
authors.initials: V
authors.lastname: Bertrand
authors.forename: J-L
authors.initials: JL
authors.lastname: Sautière
authors.forename: X
authors.initials: X
authors.lastname: Pivot
authors.forename: D
authors.initials: D
authors.lastname: Riethmuller
authors.forename: R
authors.initials: R
authors.lastname: Maillet
authors.forename: Z
authors.initials: Z
authors.lastname: Marinkovic
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000601:surgery*; D003362:Cost-Benefit Analysis; D004322:Drainage / Q000191:economics / Q000379:methods; D005260:Female; D006488:Hemostasis, Surgical / Q000191:economics / Q000295:instrumentation / Q000379:methods; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008026:Ligation / Q000191:economics / Q000295:instrumentation / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008408:Mastectomy; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome