<i>Robotic</i> versus <i>Laparoscopic Sigmoid Colectomy: Analysis of Healthcare Cost and Utilization Project Database</i>

Alharthi, Samer; Reilly, Margaret C.; Arishi, Abdulaziz; Ahmed, Amin Mohamed; Chulkov, Maria; Qu, Weikai; Ortíz, Jorge; Nazzal, Munier; Pannell, Stephanie

doi:10.1177/000313482008600337

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…In addition, RS patients had shorter mean index hospital LOS, lower conversion-to-open surgery rates and less mean hospital outpatient visits after surgery when compared to the LS group. These findings likely reflect longterm MIS colectomy benefits that include faster recovery with fewer complications and less pain [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 91%

“…The development and introduction of minimally invasive surgery (MIS) tools and approaches have fundamentally changed colorectal surgery. MIS approaches to colorectal surgery offer several outcomes advantages over traditional open surgery (OS) that include earlier return of bowel function, less postoperative pain and opioid use, shorter hospital length of stay (LOS), and fewer surgical site infections [1][2][3][4][5]. The adoption of the MIS approach to colorectal surgery increased from 40 to 60% in 2011 to 75% in 2018 [6].…”

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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: 91%

mentioning

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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“…Bastawrous et al from the United States collected data of 13,240 sigmoidectomies and concluded that laparoscopy had a higher conversion rate than robot (13.6% vs. 8.3%) [11]. Alharthi et al analyzed the data of 197,053 patients who underwent a sigmoidectomy, and reported that the robotic approach had shorter hospital stay and higher total hospital charges than laparoscopic surgery [12]. A study from Korea described that the mean operative time was longer in robotic left colectomy than in the laparoscopy with complete mesocolectomy of 73 patients, while the robot enabled dexterous dissection for the multidirectional pathway during left mesocolic mobilization [13].…”

Section: Discussionmentioning

confidence: 99%

Perioperative and long-term outcomes of robot-assisted versus laparoscopy-assisted hemicolectomy for left-sided colon cancers: a retrospective study

Zhao

Jia

et al. 2021

Updates Surg

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The objective of this study is to evaluate the perioperative and long-term outcomes of robot-assisted hemicolectomy (RAH) versus laparoscopy-assisted hemicolectomy (LAH) for left-sided colon cancers. Patients who underwent RAH and LAH from January 2012 to December 2018 were reviewed retrospectively. Patient characteristics and perioperative outcomes were compared between the two groups. Follow-up consultations were conducted to evaluate the long-term outcomes of these procedures. A total of 460 patients were included (RAH, n = 205; LAH, n = 255). There was no difference in patient characteristics between the two groups. Compared with the LAH group, the RAH group showed longer operative time (150.23 ± 43.77 min vs. 125.85 ± 38.67 min, p < 0.001) and higher surgery cost (6.33 ± 1.50 vs. 2.88 ± 0.72 thousand $, p < 0.001) and total hospital cost (14.97 ± 3.05 vs. 9.05 ± 2.31 thousand $, p < 0.001). No significant differences in tumor pathology, TNM staging, and perioperative outcomes were observed. There were no obvious differences in the 3-year and 5-year overall survival (OS) or 3-year and 5-year disease-free survival. Cox multivariate analyses showed that age, body mass index, and intravascular cancer embolus were independent risk factors for OS. Moreover, the robotic approach was not an independent risk factor for prognosis of left-sided colon cancers. RAH is an appropriate operation method for left-sided colon cancer, with perioperative and long-term outcomes comparable to those of laparoscopy. Meanwhile, RHA has longer operative time and higher cost.

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“…Many confounding variables can account for differences this diminutive, including wait times while admitted in holding prior to the procedure, operative times, and availability of transportation home on the day of discharge. A comprehensive review of the National Impatient Sample database by Alharthi et al [21] did show a meaningful difference of 4.8 days for robotic vs. 5.7 days for laparoscopic approach. This study is the only one to also look at hospital charges, and despite a shorter length of stay the robotic group still had significantly higher hospital charges.…”

Section: Length Of Staymentioning

confidence: 99%

“…It is difficult to capture cost differences regarding the procedure itself, as many studies utilize the total cost of hospitalization as their endpoint. Alharthi et al [21] looked at sigmoid colectomies and found a cost difference of $45,057 vs. $57,871 in favour of laparoscopic procedures. This margin has been repeatedly demonstrated on subsequent studies including a meta-analysis of randomized controlled trials, with a reported average higher cost of $8,000-$10,000 for robotic procedures [22,23] .…”

Section: Costmentioning

confidence: 99%

Robotic or laparoscopic surgery for rectal cancer - which is the best answer? a comprehensive review of non-oncological outcomes and learning curve

Kavalukas¹,

Ghuman²,

Sharp³

et al. 2020

Mini-invasive Surg

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Much effort has been spent evaluating the difference between robotic and laparoscopic surgery platforms for rectal cancer. There is a plethora of literature comparing outcomes for intraoperative events, postoperative complications, long term outcomes, cost, and learning curve. The data are conclusive regarding the higher cost of robotic surgery compared to laparoscopic surgery. This article is a comprehensive review of the available literature regarding intraoperative and postoperative outcomes. For practically all parameters evaluated, there are no significant differences between the two platforms. The ultimate decision on whether to perform robotic vs. laparoscopic surgery should be based on surgeon preference and familiarity with equipment, as well as local resources.

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Robotic versus Laparoscopic Sigmoid Colectomy: Analysis of Healthcare Cost and Utilization Project Database

Cited by 7 publications

References 17 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

Perioperative and long-term outcomes of robot-assisted versus laparoscopy-assisted hemicolectomy for left-sided colon cancers: a retrospective study

Robotic or laparoscopic surgery for rectal cancer - which is the best answer? a comprehensive review of non-oncological outcomes and learning curve

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