Accessibility to surgical robot technology and prostate-cancer patient behavior for prostatectomy

Sugihara, Toru; Yasunaga, Hideo; Matsui, Hiroki; Nagao, Go; Ishikawa, Akira; Fujimura, Tetsuya; Fukuhara, Hiroshi; Fushimi, Kiyohide; Ohori, Makoto; Homma, Yukio

doi:10.1093/jjco/hyx052

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…Patients themselves are contributing towards this trend as hospitals, and hospital systems, compete to maintain minimum procedure volumes. This process is occurring despite a lack of objective data on the quality differences in care [[33], [34], [35]]. Despite an overall shorter length of stay, robotic surgical patients had a significantly greater median hospital charge when compared to the laparoscopic or open approach.…”

Section: Discussionmentioning

confidence: 99%

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study

Richards

Steele

Lustik

et al. 2019

Annals of Medicine and Surgery

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Background As our nation's population ages, operating on older and sicker patients occurs more frequently. Robotic operations have been thought to bridge the gap between a laparoscopic and an open approach, especially in more complex cases like proctectomy. Methods Our objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly. A retrospective cross-sectional cohort study utilizing the Nationwide Inpatient Sample (NIS; 2006–2013) was performed. All cases were restricted to age 70 years old or greater. Results We identified 6740 admissions for rectal cancer including: 5879 open, 666 laparoscopic, and 195 robotic procedures. The median age was 77 years old. The incidence of a robotic proctectomy increased by 39%, while the open approach declined by 6% over the time period studied. Median (interquartile range) length of stay was shorter for robotic procedures at 4.3 (3–7) days, compared to laparoscopic 5.8 (4–8) and open at 6.7 (5–10) days (p < 0.01), while median total hospital charges were greater in the robotic group compared to laparoscopic and open cases ($64,743 vs. $55,813 vs. $50,355, respectively, p < 0.01). There was no significant difference in the risk of total complications between the different approaches following multivariate analysis. Conclusion Robotic proctectomy was associated with a shorter LOS, and this may act as a surrogate marker for an overall improvement in adverse events. These results demonstrate that a robotic approach is a safe and feasible option, and should not be discounted solely based on age or comorbidities.

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Section: Discussionmentioning

confidence: 99%

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study

Richards

Steele

Lustik

et al. 2019

Annals of Medicine and Surgery

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“…The DPC Research Institute (http://dpcri.or.jp/) has made a contract with each hospital for research use and confidentiality of the DPC data, and the data from agreed hospitals (≥80% of all DPC system participant hospitals) were accumulated as the DPC database. Approximately 1000 hospitals participated in this database in 2014 . The database includes discharge abstract and administrative claims data on acute‐care inpatients, including age; sex; main diagnosis, comorbidities at admission and complications emerging after admission coded by the International Statistical Classification of Diseases and Related Health Problems 10th Revision; and surgical procedures coded by the Japanese original codes.…”

Section: Methodsmentioning

confidence: 99%

“…Approximately 1000 hospitals participated in this database in 2014. 13 The database includes discharge abstract and administrative claims data on acute-care inpatients, including age; sex; main diagnosis, comorbidities at admission and complications emerging after admission coded by the International Statistical Classification of Diseases and Related Health Problems 10th Revision; and surgical procedures coded by the Japanese original codes.…”

Section: Data Sourcementioning

confidence: 99%

Tension‐free vaginal mesh surgery versus laparoscopic sacrocolpopexy for pelvic organ prolapse: Analysis of perioperative outcomes using a Japanese national inpatient database

Obinata¹,

Sugihara

Yasunaga³

et al. 2018

Int J of Urology

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“…The accessibility to robotic surgery may also be involved in the decision making of undergoing RARP. An interesting study by Sugihara et al showed a 13% reduction in RP caseload in non-robot hospitals, whereas a 101% gain in caseload was observed in hospitals with surgical robots [ 92 ]. Another study by Muralidhar et al investigated the association between travel distance and choice of treatment [ 93 ].…”

Section: Patient Preferencementioning

confidence: 99%

Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review

Yamada

Taguchi

Kume

2022

Cancers

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Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an indicator for choosing treatment options. However, determination of life expectancy can be complicated and difficult in some cases. In addition, surgical tolerability is also an important issue. Since frailty may be a major concern, it may be logical to use geriatric assessment tools to discriminate ‘surgically fit’ patients from unfit patients. Landmark studies show two valid models such as the phenotype model and the cumulative deficit model that allow for the diagnosis of frailty. Many studies have also developed geriatric screening tools such as VES-13 and G8. These tools may have the potential to directly sort out unfit patients for surgery preoperatively.

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Accessibility to surgical robot technology and prostate-cancer patient behavior for prostatectomy

Abstract: Robotic surgery accessibility within 30 km would make patients less likely select conventional surgery. The nearer a robot was, the faster the caseload reduction was.

Cited by 10 publications

References 13 publications

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study

Tension‐free vaginal mesh surgery versus laparoscopic sacrocolpopexy for pelvic organ prolapse: Analysis of perioperative outcomes using a Japanese national inpatient database

Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review

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