Abstract

SANABRIA, Álvaro  and  RAMIREZ, Adonis. Economic analysis of routine neuromonitoring of recurrent laryngeal nerve in total thyroidectomy. Biomédica [online]. 2015, vol.35, n.3, pp.363-371. ISSN 0120-4157.  https://doi.org/10.7705/biomedica.v35i3.2371.

Introduction: Thyroidectomy is a common surgery. Routine searching of the recurrent laryngeal nerve is the most important strategy to avoid palsy. Neuromonitoring has been recommended to decrease recurrent laryngeal nerve palsy. Objective: To assess if neuromonitoring of recurrent laryngeal nerve during thyroidectomy is cost-effective in a developing country. Materials and methods: We designed a decision analysis to assess the cost-effectiveness of recurrent laryngeal nerve neuromonitoring. For probabilities, we used data from a meta-analysis. Utility was measured using preference values. We considered direct costs. We conducted a deterministic and a probabilistic analysis. Results: We did not find differences in utility between arms. The frequency of recurrent laryngeal nerve injury was 1% in the neuromonitor group and 1.6% for the standard group. Thyroidectomy without monitoring was the less expensive alternative. The incremental cost-effectiveness ratio was COP$ 9,112,065. Conclusion: Routine neuromonitoring in total thyroidectomy with low risk of recurrent laryngeal nerve injury is neither cost-useful nor cost-effective in the Colombian health system.

Keywords : Thyroid gland; thyroidectomy; cost-benefit analysis; meta-analysis.

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