De la tiroidectomía a la tiroidectomía costo-efectiva. El concepto de minimalismo en cirugía tiroidea
Palabras clave:
tiroidectomía, medicina basada en la evidencia, análisis costo-eficiencia, minimalismo, thyroidectomy, evidence-based medicine, cost-efficiency analysis, minimalismResumen
La tiroidectomía constituye el procedimiento endocrino y la cirugía cervical más frecuente que realizan los cirujanos generales. Desde hace varios años, se ha evaluado la utilidad de muchos de los pasos que se realizan durante el procedimiento quirúrgico. El uso u omisión de cada uno de ellos puede aumentar o disminuir la efectividad y los costos del procedimiento global. En ese sentido, si fuera posible mantener los altos estándares de resultados del procedimiento quirúrgico, eliminado el uso de recursos que no han demostrado efectividad, sería posible lograr un impacto importante sobre la atención y distribuir mejor los recursos en otras intervenciones. El presente manuscrito muestra el proceso llevado a cabo por el autor desde hace más de 10 años, con el fin de depurar la intervención de la tiroidectomía en términos de emplear solo los pasos que se muestren efectivos, costo-efectivos y que puedan ser aplicables al contexto del sistema de salud colombiano, buscando un uso racional de los recursos quirúrgicos y una mayor calidad del servicio médico para el paciente y la familia, esto con el ánimo de desarrollar el concepto de cirugía tiroidea minimalista.
From thyroidectomy to cost-effective thyroidectomy. The concept of minimalism in surgery
Abstract
Thyroidectomy is both the most frequent endocrine procedure and cervical surgery performed by general surgeons. The usefulness of many of the steps performed during the surgical procedure has been evaluated for several years. The use or omission of each of these steps may increase or decrease the effectiveness and costs of the overall procedure. In that regard, if the high standards of thyroidectomy results could be maintained when resources not proven to be effective are eliminated, that could have a significant impact on care and those resources could be directed to other interventions. The author of this paper describes the process undertaken by him for longer than 10 years, in order to refine thyroidectomy intervention in terms of using only those steps that are effective, cost-effective and that may be applicable within the context of the colombian health system. We seek a rational use of surgical resources and greater comfort for the patient and family, aiming at framing the concept of minimalistic thyroid surgery.
Biografía del autor/a
Álvaro Sanabria, Fundación Colombiana de Cancerología- Clínica Vida
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