What About Conventional Laparoscopic Radical Cystectomy? Cost-Analysis of Open Versus Laparoscopic Radical Cystectomy

Noel, H; Leo, FossionLaurent Marie Constant

doi:10.1089/end.2013.0550

Cited by 11 publications

(8 citation statements)

References 30 publications

(35 reference statements)

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“…A recent study reported that LRC had lower costs compared to ORC (17.534 Euros compared to 22.284 Euros, respectively; p not significant). Authors emphasize that costs with disposable surgical equipment in LRC are compensated by lower transfusion rates, shorter hospital length and less intensive care admissions ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison beetwen open and laparoscopic radical cistectomy in a latin american reference center: perioperative and oncological results

et al. 2015

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Objectives:To evaluate the differences of peri-operatory and oncological outcomes between Laparoscopic Radical Cystectomy and Open Radical Cystectomy in our center.Materials and Methods:Overall, 50 patients were included in this non randomized match-pair analysis: 25 patients who had undergone Laparoscopic Radical Cystectomy for invasive bladder cancer (Group-1) and 25 patients with similar characteristics who had undergone Open Radical Cystectomy (Group-2). The patients were operated from January 2005 to December 2012 in a single Institution.Results:Mean operative time for groups 1 and 2 were 350 and 280 minutes (p=0.03) respectively. Mean blood loss was 330 mL for group 1 and 580 mL for group 2 (p=0.04). Intraoperative transfusion rate was 0% and 36% for groups 1 and 2 respectively (p=0.005). Perioperative complication rate was similar between groups. Mean time to oral intake was 2 days for group 1 and 3 days for group 2 (p=0.08). Median hospital stay was 7 days for group 1 and 13 for group 2 (p=0.04). There were no differences in positive surgical margins and overall survival, between groups.Conclusions:In a reference center with pelvic laparoscopic expertise, Laparoscopic Radical Cystectomy may be considered a safe procedure with similar complication rate of Open Radical Cystectomy. Laparoscopic Radical Cystectomy is more time consuming, with reduced bleeding and transfusion rate. Hospital stay seems to be shorter. Oncologically no difference was observed in our mid-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Comparison beetwen open and laparoscopic radical cistectomy in a latin american reference center: perioperative and oncological results

et al. 2015

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“…We initially identified 315 studies from PubMed, Web of Science, and Cochrane Library databases. Of the 315 studies, 11 were included in this study [11, 13, 19–27]. The characteristics of the included studies are listed in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Cost comparison between open radical cystectomy, laparoscopic radical cystectomy, and robot-assisted radical cystectomy for patients with bladder cancer: a systematic review of segmental costs

et al. 2019

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BackgroundRobot-assisted radical cystectomy is becoming a common treatment for bladder carcinoma. However, in comparison with open radical cystectomy, its cost-effectiveness has not been confirmed. Although few published reviews have compared total costs between the two surgical procedures, no study has compared segmental costs and explained their impact on total costs.MethodsA systematic review was conducted based on studies on the segmental costs of open, laparoscopic, and robot-assisted radical cystectomy using PubMed, Web of Science, and Cochrane Library databases to provide insight into cost-effective management methods for radical cystectomy. The segmental costs included operating, robot-related, complication, and length of stay costs. A sensitivity analysis was conducted to determine the impact of the annual number of cases on the per-case robot-related costs.ResultsWe identified two studies that compared open and laparoscopic surgeries and nine that compared open and robotic surgeries. Open radical cystectomy costs were higher than those of robotic surgeries in two retrospective single-institution studies, while robot-assisted radical cystectomy costs were higher in 1 retrospective single-institution study, 1 randomized controlled trial, and 4 large database studies. Operating costs were higher for robotic surgery, and accounted for 63.1–70.5% of the total robotic surgery cost. Sensitivity analysis revealed that robot-related costs were not a large proportion of total surgery costs in institutions with a large number of cases but accounted for a large proportion of total costs in centers with a small number of cases.ConclusionsThe results show that robot-assisted radical cystectomy is more expensive than open radical cystectomy. The most effective methods to decrease costs associated with robotic surgery include a decrease in operating time and an increase in the number of cases. Further research is required on the cost-effectiveness of surgeries, including quality measures such as quality of life and quality-adjusted life years.

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“…Laparoscopic surgery is suggested to have crucial advantages in terms of reduced postoperative pain, shorter hospital stay, less analgesic requirement, and faster recovery time. Laparoscopic surgery including RPS has been continued to be used and developed over the past decade to improve cosmetic results and to reduce patient invasiveness (Hermans et al, 2014;Tang et al, 2014;Aboumarzouk et al, 2013).…”

Section: Outcomes and Complications Of Simultaneous Laparoscopic Cystmentioning

confidence: 99%

Outcomes and Complications of Simultaneous Laparoscopic Cystectomy and Laparoscopic Nephroureterectomy with Umbilical Reduced Port Surgery

Tanaka

Okamura

Chaya

et al. 2018

Asian Pac J Cancer Prev

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Objective: In recent years, although reduced port surgeries (RPS) have been reported for many urological diseases, there have been no reports regarding simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPS. Therefore, the aim of this study was to evaluate outcomes and complications of simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPS. Methods: We performed a preliminary case series of 4 patients with synchronous upper urinary tract (UUT) tumor and invasive bladder cancer who underwent simultaneous laparoscopic cystectomy and unilateral or bilateral nephroureterectomy with umbilical RPS between 2014 and 2017 at our hospital. Demographic data, pathologic features, the surgical technique, and outcomes were retrospectively analyzed. Result: All 4 patients were men whose median age was 79 years (range 65-85 years) and median body mass index was 24.2 kg/m 2 (range 21.5-27.3 kg/m 2 ). The laparoscopic approach was technically successful in all 4 patients without the need for open conversion. The median total operative time was 434 minutes (range 372-481 minutes). The median estimated blood loss was 773 ml (range 153-923 ml), median interval to resuming oral intake was 2 days (range 1-7 days), and median hospital stay was 16 days (range 13-20 days). Conclusion: The reduced port approach is technically feasible in terms of many outcome measures, with significant cosmetic advantages. This method can be performed safely and recommended as a viable option for patients with concomitant UUT and bladder cancer.

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What About Conventional Laparoscopic Radical Cystectomy? Cost-Analysis of Open Versus Laparoscopic Radical Cystectomy

Abstract: Within our series, LRC is a cost neutral minimally invasive alternative to ORC without comprising quality of care and with beneficial perioperative outcomes.

Cited by 11 publications

References 30 publications

Comparison beetwen open and laparoscopic radical cistectomy in a latin american reference center: perioperative and oncological results

Comparison beetwen open and laparoscopic radical cistectomy in a latin american reference center: perioperative and oncological results

Cost comparison between open radical cystectomy, laparoscopic radical cystectomy, and robot-assisted radical cystectomy for patients with bladder cancer: a systematic review of segmental costs

Outcomes and Complications of Simultaneous Laparoscopic Cystectomy and Laparoscopic Nephroureterectomy with Umbilical Reduced Port Surgery

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