Neue Techniken und Trainingsmethoden für die roboterassistierte Chirurgie und Kosten-Nutzen-Bewertung anhand der Ivor-Lewis-Ösophagektomie

Urbanski, Alexander; Babic, Benjamin; Schröder, Wolfgang; Schiffmann, Leif; Müller, Dolores T.; Bruns, Christiane; Fuchs, Hans

doi:10.1007/s00104-020-01317-1

Cited by 8 publications

(3 citation statements)

References 21 publications

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“…Existing literature on the economic aspects of RAMIE is limited. A German review suggested higher costs for RAMIE compared to hybrid esophagectomy, but lacked statistical analysis or a detailed cost breakdown, making direct comparisons difficult [ 24 ]. A propensity-score matched study from India found significantly higher costs for RAMIE in both matched and non-matched cohorts, but also lacked a detailed cost breakdown and had a small patient sample [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies have reported higher financial expenses for robotic liver surgery compared to laparoscopic or open surgery [ 19 , 20 ], while others have shown equal or even lower costs [ 21 , 22 ]. Limited data is available regarding RAMIE: So far, reports from India [ 23 ], Germany [ 24 ] and the United States [ 25 ] have demonstrated higher financial expenses for RAMIE compared to MIE. Whether these cost differences can be offset by the potential benefits of RAMIE remains unclear [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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Robotic-Assisted Ivor Lewis Esophagectomy Is Safe and Cost Equivalent Compared to Minimally Invasive Esophagectomy in a Tertiary Referral Center

Knitter,

Maurer,

Winter

et al. 2023

Cancers

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In recent decades, robotic-assisted minimally invasive esophagectomy (RAMIE) has been increasingly adopted for patients with esophageal cancer (EC) or cancer of the gastroesophageal junction (GEJ). However, concerns regarding its costs compared to conventional minimally invasive esophagectomy (MIE) have emerged. This study examined outcomes and costs of RAMIE versus total MIE in 128 patients who underwent Ivor Lewis esophagectomy for EC/GEJ at our department between 2017 and 2021. Surgical costs were higher for RAMIE (EUR 12,370 vs. EUR 10,059, p < 0.001). Yet, median daily (EUR 2023 vs. EUR 1818, p = 0.246) and total costs (EUR 30,510 vs. EUR 29,180, p = 0.460) were comparable. RAMIE showed a lower incidence of postoperative pneumonia (8% vs. 25%, p = 0.029) and a trend towards shorter hospital stays (15 vs. 17 days, p = 0.205), which may have equalized total costs. Factors independently associated with higher costs included readmission to the intensive care unit (hazard ratio [HR] = 7.0), length of stay (HR = 13.5), anastomotic leak (HR = 17.0), and postoperative pneumonia (HR = 5.4). In conclusion, RAMIE does not impose an additional financial burden. This suggests that RAMIE may be considered as a valid alternative approach for esophagectomy. Attention to typical cost factors can enhance postoperative care across surgical methods.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Ivor Lewis Esophagectomy Is Safe and Cost Equivalent Compared to Minimally Invasive Esophagectomy in a Tertiary Referral Center

Knitter,

Maurer,

Winter

et al. 2023

Cancers

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“…B. Medtronic Hugo und roboterähnliche Devices wie z. B. SymphonX eingehen [29]. Insbesondere der immer wieder kritisierte Kostenaspekt wurde in dieser Arbeit auch bereits für unser Zentrum analysiert.…”

Section: Neue Chirurgische Technologieunclassified

Chirurgische Therapie des Ösophaguskarzinoms – neue Technologien, moderne Konzepte

Schmidt

Babic

Bruns

et al. 2022

best practice onkologie

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Chirurgische Therapie des Ösophaguskarzinoms -neue Technologien, moderne Konzepte Hintergrund Das Ösophaguskarzinom wird in Deutschland meist in spezialisierten Zentren entsprechend den Leitlinien multimodal und interdisziplinär therapiert [1]. In Studien kommen zunehmend innovative Konzepte zur Neoadjuvanz, Adjuvanz oder zu perioperativen Therapien zum Einsatz, zusätzlich werden Konzepte ohne Chirurgie ("active surveillance") untersucht [2, 3]. Daneben werden die etablierten Therapiekonzepte mit einer neoadjuvanten Radiochemotherapie (CROSS[Carboplatin/ Paclitaxel]-Protokoll) und einer perioperativen Chemotherapie (FLOT[5-Fluorouracil, Leucovorin, Oxaliplatin, Docetaxel]-Protokoll) verglichen und es wurde die adjuvante Immunthe-

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Chirurgische Therapie des Ösophaguskarzinoms – neue Technologien, moderne Konzepte

Schmidt

Babic

Bruns

et al. 2021

Chirurg

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Surgical treatment of esophageal cancer-New technologies, modern conceptsIn Germany esophageal cancer is mostly treated in specialized centers according to national and international guidelines in a multimodal and interdisciplinary setting. In the next few years centralization of esophageal surgery will continue in Germany due to new national regulations on minimum case volumes. This article highlights new technologies for surgical treatment of esophageal cancer and also depicts the current oncological concepts from the perspective of a high-volume center.

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Neue Techniken und Trainingsmethoden für die roboterassistierte Chirurgie und Kosten-Nutzen-Bewertung anhand der Ivor-Lewis-Ösophagektomie

Cited by 8 publications

References 21 publications

Robotic-Assisted Ivor Lewis Esophagectomy Is Safe and Cost Equivalent Compared to Minimally Invasive Esophagectomy in a Tertiary Referral Center

Robotic-Assisted Ivor Lewis Esophagectomy Is Safe and Cost Equivalent Compared to Minimally Invasive Esophagectomy in a Tertiary Referral Center

Chirurgische Therapie des Ösophaguskarzinoms – neue Technologien, moderne Konzepte

Chirurgische Therapie des Ösophaguskarzinoms – neue Technologien, moderne Konzepte

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