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BronchoscopyNd-YAG Laser vs Bronchoscopic Electrocautery for Palliation of Symptomatic Airway Obstruction: A Cost-Effectiveness Study
Section snippets
Materials and Methods
Patients included in this study had centrally located inoperable NSCLC and underwent bronchoscopic treatment between January 1994 and December 1996 because of dyspnea due to tracheobronchial obstruction caused by intraluminal tumor. Between January 1994 and March 1995, the laser (Nd-YAG; Sharplan Lasers, Allendale, NJ) was used; between March 1995 and December 1996, electrocautery was used. We had to use electrocautery (Valleylab; Boulder, CO) because of technical problems with our only Nd-YAG
Results
Thirty-one patients were included: 14 were treated with the Nd-YAG laser and 17 with electrocautery. Patient groups were comparable regarding age, sex, diagnosis, site of obstruction, time after intial diagnosis, and previous and current antitumor therapy (Table 1). General anesthesia was used more often in patients treated with the Nd-YAG laser. Improvement of symptoms was achieved in about 70% of patients in both treatment groups. No complications related to treatment technique were found in
Discussion
Duration of hospital stay was the most important factor determining costs of treatment in our hospital, expressed as the monetary amount of the claim submitted to the health insurance company. No differences in costs of services directly related to bronchoscopic treatment (eg, number of treatment sessions and bronchoscopic sessions) were found. The use of general anesthesia, which was more frequent in the group treated with the Nd-YAG laser, may have been a factor determining the longer
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