Robotic versus Conventional Laparoscopic Surgery for Rectal Cancer: A Cost Analysis from A Single Institute in Korea
Robotic versus Conventional Laparoscopic Surgery for Rectal Cancer: A Cost Analysis from A Single Institute in Korea
复制标题
DOI：
10.1007/s00268-012-1728-4
复制
发表时间：
2012-11-01
影响因子：
2.6
通讯作者：
Kim, Jin
中科院分区：
文献类型：
--
作者：
Baek, Se-Jin;Kim, Seon-Hahn;Kim, Jin
机器人手术自问世以来，在多个微创手术领域得到了积极的应用，在结直肠外科领域的应用也在不断增加。到目前为止，在这些研究中，可行性和安全性一直是主要关注的焦点，但其中涉及的经济学问题值得研究。对2007年7月至2010年8月在韩国大学Anam医院接受机器人和腹腔镜直肠癌切除术的患者的临床特征、住院总费用、费用、手术室费用和医院利润进行了分析。除肿瘤部位(6.7vs8.7 cm，P=0.043)、术前放化疗(22.7vs8%，p=0.001)和手术时间(285.2 vs8.0min，p=0.018)外，两组患者的人口学特征相似。两组的术后病程和并发症也相似。以美元计算的住院总费用(14,647美元比9,978美元；p=0.001)和患者支付的费用(11,540美元比3,956美元；p<；0.001)要高得多。机器人组的医院利润明显低于腹腔镜组(689美元对1,671美元；P<；0.001)。机器人辅助直肠癌手术比腹腔镜组更昂贵。考虑到机器人手术可以更容易地应用于低位癌症，机器人直肠癌手术的成本效益应该根据未来研究的肿瘤学结果和功能结果进行评估。
Since its introduction, robotic surgery has been applied actively in several fields of minimally invasive surgery, and its use in the field of colorectal surgery is also increasing. In the studies to date, feasibility and safety have been the main focus, but the economics involved are important to examine. We compared the economics of robotic surgery with those of laparoscopic surgery for rectal cancer.We analyzed the clinical characteristics, total hospital charges, payments, operating room costs, and hospital profits for patients who underwent robotic and laparoscopic resection of rectal cancer at Korea University Anam Hospital between July 2007 and August 2010.From July 2007 and August 2010, 154 robot-assisted and 150 laparoscopic rectal surgeries were performed. The patient demographics were similar in the two groups with the exception of tumor location (6.7 vs 8.7 cm distal to the anal verge; p = 0.043), preoperative chemoradiotherapy (22.7 vs 8 %; p = 0.001), and operative time (285.2 vs 219.7 min; p = 0.018). Postoperative course and complications were also similar in the two groups. The total hospital charges in U.S. dollars ($14,647 vs $9,978; p = 0.001) and payments made by patients ($11,540 vs $3,956; p < 0.001) were significantly higher in the robotic group. Hospital profit was significantly lower in the robotic group than in the laparoscopic group ($689 vs $1,671; p < 0.001).Robot-assisted surgery is more expensive than laparoscopic surgery for rectal cancer. Considering that robotic surgery can be applied more easily for low-lying cancers, the cost-effectiveness of robotic rectal cancer surgery should be assessed based on oncologic outcomes and functional results from future studies.