Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy: a cost-effective analysis.
OBJECTIVE
To compare the cost of minimally invasive video-assisted thyroidectomy (MIVAT) with conventional thyroidectomy.


METHODS
A cost-effectiveness study and chart review.


METHODS
Academic university hospital.


METHODS
Pediatric and adult patients referred to the Department of Otolaryngology-Head and Neck Surgery for suspicious thyroid nodules, goiters, or known carcinomas. A tertiary care hospital's billing department was queried for all hemithyroidectomies and total thyroidectomies completed by the Department of Otolaryngology-Head and Neck Surgery between January 5, 2006, and November 1, 2007. The charges, including surgery, hospital, pathology, and anesthesia, for minimally invasive video-assisted thyroidectomy (MIVAT) and traditional or minimally invasive open thyroidectomies meeting MIVAT inclusion criteria were then reviewed retrospectively and compared statistically.


RESULTS
A total of 185 thyroidectomies were performed, 50.3 percent of which met criteria for MIVAT. Length of stay (days) was significantly shorter for patients undergoing MIVAT hemithyroidectomy (mean difference -0.8; 95% confidence interval [95% CI] -1.08 to -0.52) and not significantly different between groups for total thyroidectomy (mean difference 0.1; 95% CI -0.36 to 0.56). Mean anesthesia cost (U.S.$) was similar between groups for hemi- and total thyroidectomies. MIVAT mean pathology cost was significantly less than open thyroidectomy for hemithyroidectomy (mean difference -89.9; 95% CI -179.01 to -0.79) and approached significance for total thyroidectomy. There was no significant difference in hospital cost and total cost for hemithyroidectomy and total thyroidectomy.


CONCLUSIONS
In a group of matched cohorts, the cost of MIVAT appears to be equal to that of open thyroidectomy.
Department of Otolaryngology-Health and Neck Surgery, Medical University of South Carolina, Charleston, SC 29425, USA. byrdj@musc.edu
J Kenneth
JK
Byrd
Shaun A
SA
Nguyen
Amy
A
Ketcham
Joshua
J
Hornig
M Boyd
MB
Gillespie
Eric
E
Lentsch
D000328:Adult; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000191:economics* / Q000379:methods*; D020535:Video-Assisted Surgery / Q000191:economics*