Cost-effectiveness of one-stage versus two-stage breast reconstruction in the United Kingdom
نویسندگان
چکیده
Aim: Permanent expanders allow for breast reconstruction as a single stage. These prostheses are more expensive than conventional tissue expanders, but this excess cost is markedly offset as only one operation is required. However, if the revision rate is sufficiently high, then this effect is negated. We aim to compare costs of one-stage vs. two-stage reconstruction at a single center, taking into account explantation and unexpected admissions following complications. Methods: A retrospective review was carried out on all patients who underwent one-stage and two-stage reconstruction over a 5-year period by a single surgeon. A cost analysis was performed taking into account, explantation and additional admissions. Results: One hundred and forty-three one-stage and 45 two-stage procedures were included. The explantation rate for one-stage procedures is 36%, at a mean of 12.9 months postimplantation, the majority of which were exchanged for silicone implants to improve cosmesis. Four (9%) of the two-stage procedures were explanted a mean of 18 months postreconstruction. Overall, one-stage reconstructions were significantly more expensive than the two-stage group (P = 0.016). Conclusion: There are many benefits of one-stage breast reconstruction. However, it does not appear to be cost-effective when additional admissions for explantation surgery are taken into account.
منابع مشابه
Nipple Reconstruction Using the C-V Flap Technique: Long-Term Outcomes and Patient Satisfaction
BACKGROUND Nipple creation using the C-V flap technique is often the final step in breast reconstruction. The aim of this study was to subjectively and objectively assess the cosmetic outcomes and satisfaction of patients undergoing C-V flap nipple reconstruction. METHODS Subjective assessments of patient satisfaction with the neo-nipple were recorded by visual analogue scoring (VAS; 0...
متن کاملCost comparison of immediate one-stage and tissue-expander breast reconstructions after mastectomy in commercially insured patients.
OBJECTIVE Growing acceptance of nipple-sparing mastectomy and rising rates of prophylactic mastectomy due to genetic findings make immediate one-stage implant breast reconstruction an attractive option for many American women facing post-mastectomy breast reconstruction. We compared medical services utilization and cost of immediate one-stage reconstruction with that of the more common tissue-e...
متن کاملTwo-Stage Stochastic Day-Ahead Market Clearing in Gas and Power Networks Integrated with Wind Energy
The significant penetration rate of wind turbines in power systems made some challenges in the operation of the systems such as large-scale power fluctuations induced by wind farms. Gas-fired plants with fast starting ability and high ramping can better handle natural uncertainties of wind power compared to other traditional plants. Therefore, the integration of electrical and natural gas syste...
متن کاملThe costs of treating breast cancer in the United Kingdom: implications for screening.
Total treatment costs by stage at diagnosis are estimated for a sample of breast cancer patients. At 4 years, stage 4 cancers emerge as being more expensive to treat than those at earlier stages, although this difference fails to achieve significance when expected lifetime costs are considered. The inclusion of treatment cost estimates in a screening model indicates that screening may increase ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره شماره
صفحات -
تاریخ انتشار 2016