Comparison of outcome and costs of robotic and laparoscopic right hemicolectomies

被引:11
作者
Ahmadi, Nima [1 ]
Mor, Isabella [1 ,2 ]
Warner, Ross [1 ,2 ]
机构
[1] Tweed Hosp, Dept Colorectal Surg, Powell St, Tweed Heads, NSW 2485, Australia
[2] John Flynn Private Hosp, Dept Colorectal Surg, Tugun, Qld 4224, Australia
关键词
Colectomy; Laparoscopy; Robotic surgical procedures; Patient outcome assessment; Costs and cost analysis; SHORT-TERM OUTCOMES; RIGHT COLECTOMY; EXTRACORPOREAL ANASTOMOSIS; SIGMOID COLECTOMIES; RECTAL RESECTION; COLON-CANCER; SURGERY; INTRACORPOREAL; METAANALYSIS; EXCISION;
D O I
10.1007/s11701-021-01246-z
中图分类号
R61 [外科手术学];
学科分类号
摘要
To compare the outcomes of patients undergoing right hemicolectomy using laparoscopic or robotic approaches and perform a cost analysis. Retrospective review of all patients undergoing elective laparoscopic and robotic right hemicolectomies at a public and private hospital in NSW/QLD from January 2015 to June 2018. Cost analysis was calculated using actual and estimated costs by the local health district. A total of 101 patients were identified. 59 (58%) had Robotic resection, of which 44 (75%) had an intra-corporeal anastomosis. There were no demographic or oncological differences between the two groups. The robotic group had a significantly earlier time to bowels opening (2 vs 4 days, p < 0.001) and shorter length of stay (3 vs 5 days, p < 0.001). The robotic group had a lower rate of ileus (2% vs 14%, p = 0.02) and complications (5% vs 33%, p = 0.006). The mean lymph node harvest was higher in the robotic group (18 vs 14, p = 0.001). The operative time was longer in the robotic group (110 vs 97 min, p = 0.021). The total instrument costs of robotic surgery were A$2565.37 compared with $1507.50 for laparoscopic surgery. The cost of bed days was A$1167.00/day. The average difference in cost of care was calculated as A$1276.13 and A$464.43 less in the robotic with intra-corporeal and extra-corporeal anastomosis, respectively. Patients have significantly faster return to bowel function and shorter length of stay after Robotic vs laparoscopic right hemicolectomy and experience fewer complications. This difference in length of stay may make robotic right hemicolectomies more cost effective.
引用
收藏
页码:429 / 436
页数:8
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