Cost-utility analysis of the insufflation of warmed humidified carbon dioxide during open and laparoscopic colorectal surgery

摘要

Background: An evaluation was conducted to estimate the cost-effectiveness of insufflation of warmed humidified CO2 during open and laparoscopic colorectal surgery compared with usual care from a UK NHS perspective.Methods: Decision analytic models were developed for open and laparoscopic surgery. Incremental costs per quality-adjusted life year (QALY) were estimated. The open surgery model used data on the incidence of intra-operative hypothermia and applied risks of complications for hypothermia and normothermia. The laparoscopic surgery model utilised data describing complications directly. Sensitivity analyses were conducted.Results: Compared with usual care, insufflation of warmed humidified CO2 dominated. For open surgery, savings of 20 and incremental QALYs of 0.013 were estimated per patient. For laparoscopic surgery, savings of 345 pound and incremental QALYs of 0.001 per patient were estimated. Results were robust to most sensitivity analyses.Conclusions: Considering the current evidence base, the intervention is likely to be cost-effective compared with usual care in patients undergoing colorectal surgery.