Robotic-assisted right colectomy versus laparoscopic approach: case-matched study and cost-effectiveness analysis

Ferri, Valentina; Quijano, Yolanda; Núñez, Jesús Roberto Garay; Caruso, Riccardo; Durán, Hipólito; Dı́az, Eduardo; Fabra, Isabel; Malavé, L.; Isernia, Roberta; D’Ovidio, Angelo; Agresott, Ruben; Gomez, Patricio; Isojo, Rigoberto; Vicente, Emilio

doi:10.1007/s11701-020-01084-5

Cited by 22 publications

(26 citation statements)

References 12 publications

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“…Like laparoscopic colorectal surgery, the cost of RS has decreased with time and experience, likely due to reductions in operative time, LOS, conversion-to-open, standardized surgical protocols, and surgeon volume defined as ≥ 30 cases per year [8,[24][25][26]. Previous studies have shown mixed results comparing LS and RS cost-effectiveness [2,8,16,24,27]. A National Inpatient Sample database comparison of LS and RS sigmoid colectomy showed that LOS was significantly shorter for RS but that total hospital charges were significantly higher [2].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to our study, this database analysis relied on ICD-9 procedure codes and hospital charges, included an earlier time period than ours (2014 vs 2018), and may have included more patients in the robotic learning curve with longer operative times and more instrument needs. Using an incremental cost-effectiveness ratio, estimated using overall costs and quality-adjusted life years, another recent comparison of LS and RS approaches for right colon cancer showed that there was no significant difference in costs between groups and that there was a 78.78-95.04% probability that the RS group was more cost effective compared to the LS group [27]. Our study showed no difference in mean expenditures between RS and LS approaches for all categories except physician payments (LS > RS, p = 0.01) at index surgery.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of health-care utilization and expenditures for minimally invasive vs. open colectomy for benign disease

et al. 2022

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Background Adoption of minimally invasive approaches continues to increase, and there is a need to reassess outcomes and cost. We aimed to compare open versus minimally invasive colectomy short- and long-term health-care utilization and payer/patient expenditures for benign disease. Methods This is a retrospective analysis of IBM® MarketScan® Database patients who underwent left or right colectomy for benign disease between 2013 and 2018. Outcomes included total health-care expenditures, resource utilization, and direct workdays lost up to 365 days following colectomy. The open surgical approach (OS) was compared to minimally invasive colectomy (MIS) with subgroup analysis of laparoscopic (LS) and robotic (RS) approaches using inverse probability of treatment weighting. Results Of 10,439 patients, 2531 (24.3%) had open, 6826 (65.4%) had laparoscopic, and 1082 (10.3%) had robotic colectomy. MIS patients had shorter length of stay (LOS; mean difference, − 1.71, p < 0.001) and lower average total expenditures (mean difference, − $2378, p < 0.001) compared with open patients during the index hospitalization. At 1 year, MIS patients had lower readmission rates, and fewer mean emergency and outpatient department visits than open patients, translating into additional savings of $5759 and 2.22 fewer days missed from work for health-care visits over the 365-day post-discharge period. Within MIS, RS patients had shorter LOS (mean difference, − 0.60, p < 0.001) and lower conversion-to-open rates (odds ratio, 0.31 p < 0.001) during the index hospitalization, and lower hospital outpatient visits (mean difference, − 0.31, p = 0.001) at 365 days than LS. Conclusion MIS colectomy is associated with lower mean health-care expenditures and less resource utilization compared to the open approach for benign disease at index operation and 365-days post-discharge. Health-care expenditures for LS and RS are similar but shorter mean LOS and lower conversion-to-open surgery rates were observed at index operation for the RS approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of health-care utilization and expenditures for minimally invasive vs. open colectomy for benign disease

et al. 2022

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“…Most studies were then excluded because they did not meet the “cost‐utility analyses” criterion, or because they were not primary studies reporting results of an economic evaluation (e.g., reviews), or because they were duplicates. After the full‐text screening, 31 studies 31–61 were included for data extraction and quality assessment. Further details are presented in the PRISMA flow diagram (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 lists the characteristics and main findings of the included studies. Thirty‐one 31–61 eligible studies evaluated CUAs of robotic surgery compared with that of laparoscopic surgery, open surgery, and (chemo) radiotherapy, and they were published between 2011 and 2020. Studies were conducted in the following countries: USA ( n = 8 31,33,36,42,49,58,60,61 ), Spain ( n = 8 43,45,47,48,50,51,54,59 ), Canada ( n = 5 35,37,39,41,57 ), UK ( n = 2 32,44 ), Thailand ( n = 2 34,40 ), Finland ( n = 1 46 ), Italy ( n = 1 53 ), Japan ( n = 1 55 ), Lebanon ( n = 1 38 ), Sweden ( n = 1 56 ), and China ( n = 1 52 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐one 31–61 eligible studies evaluated CUAs of robotic surgery compared with that of laparoscopic surgery, open surgery, and (chemo) radiotherapy, and they were published between 2011 and 2020. Studies were conducted in the following countries: USA ( n = 8 31,33,36,42,49,58,60,61 ), Spain ( n = 8 43,45,47,48,50,51,54,59 ), Canada ( n = 5 35,37,39,41,57 ), UK ( n = 2 32,44 ), Thailand ( n = 2 34,40 ), Finland ( n = 1 46 ), Italy ( n = 1 53 ), Japan ( n = 1 55 ), Lebanon ( n = 1 38 ), Sweden ( n = 1 56 ), and China ( n = 1 52 ). As regards the clinical condition, most studies focused on prostatectomy ( n = 6 32–34,41,55,57 ), followed by proctectomy ( n = 4 43,46,59,60 ) and transoral surgery ( n = 4 35–37,39 ).…”

Section: Resultsmentioning

confidence: 99%

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More work is needed on cost‐utility analyses of robotic‐assisted surgery

Bai

Han

et al. 2022

J Evidence Based Medicine

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Objective:To comprehensively analyze the cost-utility of robotic surgery in clinical practice and to investigate the reporting and methodological quality of the related evidence.Methods: Data on cost-utility analyses (CUAs) of robotic surgery were collected in seven electronic databases from the inception to July 2021. The quality of the included studies was assessed using the CHEERs and QHES checklists. A systematic review was performed with the incremental cost-effectiveness ratio as the outcome of interest.Results: Thirty-one CUAs of robotic surgery were eligible. Overall, the identified CUAs were fair to high quality, and 63% of the CUAs ranked the cost-utility of robotic surgery as "favored," 32% categorized as "reject," and the remaining 5% ranked as "unclear."Although a high heterogeneity was present in terms of the study design among the included CUAs, most studies (81.25%) consistently found that robotic surgery was more cost-utility than open surgery for prostatectomy

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Costs in Robotic Colorectal Surgery

Marano,

Borghi

2023

Updates in Surgery

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Robotic-assisted right colectomy versus laparoscopic approach: case-matched study and cost-effectiveness analysis

Cited by 22 publications

References 12 publications

Comparison of health-care utilization and expenditures for minimally invasive vs. open colectomy for benign disease

Comparison of health-care utilization and expenditures for minimally invasive vs. open colectomy for benign disease

More work is needed on cost‐utility analyses of robotic‐assisted surgery

Costs in Robotic Colorectal Surgery

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