The Effect of Transoral Robotic Surgery on Short-Term Outcomes and Cost of Care After Oropharyngeal Cancer Surgery
The Effect of Transoral Robotic Surgery on Short-Term Outcomes and Cost of Care After Oropharyngeal Cancer Surgery
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DOI：
10.1002/lary.24358
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发表时间：
2014-01-01
期刊：
影响因子：
2.6
通讯作者：
Gourin, Christine G.
中科院分区：
文献类型：
--
作者：
Richmon, Jeremy D.;Quon, Harry;Gourin, Christine G.
目的/假设经口手术是上呼吸消化道肿瘤越来越常见的治疗方式。这在很大程度上与用于口咽癌切除的经口机器人手术（TORS）的引入有关，该手术已表现出出色的肿瘤学和功能结果。然而，关于 TORS 与传统开放手术在总体成本和住院时间方面的比较，数据有限。随着控制和降低医疗费用的压力越来越大，我们试图评估 TORS 对全国接受口咽癌手术患者样本的影响。研究设计回顾性横断面研究。方法使用全国住院患者样本的出院数据，对 2008 年至 2009 年接受口咽恶性肿瘤摘除手术的 9,601 名患者进行横断面分析。结果 TORS 116 例 (1.2%) 病例进行了此项检查。与接受非 TORS 手术的患者相比，TORS 患者的胃造口管置入率（0% vs. 19%）、气管切开管置入率（0% vs. 36%）和非常规出院率（0% vs. 44%）较低。在控制了所有其他变量（包括合并症、手术范围和教学医院状况）后，TORS 与显着缩短的住院时间（平均 -1.5 天）和医院相关费用（平均 -4,285 美元）相关。 结论 TORS 正在成为治疗上呼吸消化道肿瘤的越来越常用的技术。这些数据表明，与其他手术技术相比，TORS 与住院时间和医院相关费用的缩短有关。
Objectives/HypothesisTransoral surgery is an increasingly frequent treatment modality for tumors of the upper aerodigestive tract. This is in large part related to the introduction of transoral robotic surgery (TORS) for oropharyngeal cancer resection, which has demonstrated excellent oncologic and functional outcomes. There is limited data, however, on how TORS compares to traditional open surgery in overall costs and length of hospitalization. With increasing pressure to contain and reduce the costs of medical care, we sought to evaluate the impact of TORS on a national sample of patients undergoing surgery for oropharyngeal cancer.Study DesignRetrospective cross-sectional study.MethodsA cross-sectional analysis of 9,601 patients who underwent an extirpative procedure for a malignant oropharyngeal neoplasm in 2008 to 2009 was performed using discharge data from the Nationwide Inpatient Sample.ResultsTORS was performed in 116 (1.2%) of cases. TORS patients had a lower rate of gastrostomy tube placement (0% vs. 19%), tracheotomy tube placement (0% vs. 36%), and nonroutine discharge (0% vs. 44%) compared to patients undergoing non-TORS procedures. After controlling for all other variables, including comorbidity, extent of surgery, and teaching hospital status, TORS was associated with significantly decreased length of hospitalization (mean, -1.5 days) and hospital-related costs (mean, -$4,285).ConclusionsTORS is becoming an increasingly frequent technique to treat tumors of the upper aerodigestive tract. These data demonstrate that TORS is associated with a decreased length of hospitalization and hospital-related costs compared to other surgical techniques.