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Clinical outcomes and cost-benefit analysis comparing laparoscopic and robotic colorectal surgeries.
Surg Endosc 2016; 30(12):5490-5493SE

Abstract

BACKGROUND

The introduction of minimally invasive platforms for colorectal surgery-laparoscopy and more recently robotics-allows for smaller incisions, shortened hospital stay, less postoperative pain, and quicker return to normal activity. There exists a lack of evidence-based knowledge comparing the clinical outcomes and cost-benefit analysis of the different types of minimally invasive surgery. The aim of this study was to analyze and compare the short-term clinical outcomes and overall hospital costs between laparoscopic and robotic colorectal surgery.

METHODS

After IRB approval, we conducted a retrospective chart review from 131 patients who underwent laparoscopic colorectal surgery and 96 patients who underwent robotic colorectal surgery. Data analyzed included pertinent patient demographics, operative times (OR times), conversion rates, postoperative pathology, complications, length of hospital stay, 90-day readmission rates, 30-day mortality, and overall hospital costs.

RESULTS

Two hundred and twenty-seven patients were included-laparoscopic (N = 131) and robotic (N = 96) colorectal surgeries. Mean age of patients in the laparoscopic versus robotic cohort was 70.9 vs 63.6 years, (p < 0.001). Around 62 % were operated on for malignant disease. Mean OR time was 113 min for laparoscopy and 109 min for robotics, p = 0.59. Conversion rates were comparable. Mean length of hospital stay (6.6 vs 5.7 days) and postoperative complications (3.2 vs 7 %) were comparable between the laparoscopic and robotic arms. Overall hospital charges were $114,853 for laparoscopy and $107,220 for robotics, and no significant difference was noted (p = 0.448, NS).

CONCLUSION

Robotic colectomies were comparable to laparoscopic colectomies in terms of overall hospital charges and short-term clinical outcomes, including length of stay and conversion rates. Robotic surgery was favored for left-sided colectomy. With shorter learning curves and wider availability, robotic approach offers a safe and economically feasible minimally invasive platform for complex colorectal resections.

Authors+Show Affiliations

Center for Advanced Surgical Oncology, Palmetto General Hospital, Hialeah, FL, USA. vanithajosh@gmail.com.Division of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA. rreusche07@gmail.com.Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA.Department of General Surgery, University of Miami Palm Beach Regional Campus, Atlantis, FL, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27126626

Citation

Vasudevan, Vanitha, et al. "Clinical Outcomes and Cost-benefit Analysis Comparing Laparoscopic and Robotic Colorectal Surgeries." Surgical Endoscopy, vol. 30, no. 12, 2016, pp. 5490-5493.
Vasudevan V, Reusche R, Wallace H, et al. Clinical outcomes and cost-benefit analysis comparing laparoscopic and robotic colorectal surgeries. Surg Endosc. 2016;30(12):5490-5493.
Vasudevan, V., Reusche, R., Wallace, H., & Kaza, S. (2016). Clinical outcomes and cost-benefit analysis comparing laparoscopic and robotic colorectal surgeries. Surgical Endoscopy, 30(12), pp. 5490-5493.
Vasudevan V, et al. Clinical Outcomes and Cost-benefit Analysis Comparing Laparoscopic and Robotic Colorectal Surgeries. Surg Endosc. 2016;30(12):5490-5493. PubMed PMID: 27126626.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical outcomes and cost-benefit analysis comparing laparoscopic and robotic colorectal surgeries. AU - Vasudevan,Vanitha, AU - Reusche,Ryan, AU - Wallace,Hannah, AU - Kaza,Srinivas, Y1 - 2016/04/28/ PY - 2015/10/17/received PY - 2016/04/02/accepted PY - 2016/4/30/pubmed PY - 2017/8/8/medline PY - 2016/4/30/entrez KW - Colectomy KW - Colorectal surgery KW - Cost–benefit KW - Laparoscopy KW - Robotic-assisted SP - 5490 EP - 5493 JF - Surgical endoscopy JO - Surg Endosc VL - 30 IS - 12 N2 - BACKGROUND: The introduction of minimally invasive platforms for colorectal surgery-laparoscopy and more recently robotics-allows for smaller incisions, shortened hospital stay, less postoperative pain, and quicker return to normal activity. There exists a lack of evidence-based knowledge comparing the clinical outcomes and cost-benefit analysis of the different types of minimally invasive surgery. The aim of this study was to analyze and compare the short-term clinical outcomes and overall hospital costs between laparoscopic and robotic colorectal surgery. METHODS: After IRB approval, we conducted a retrospective chart review from 131 patients who underwent laparoscopic colorectal surgery and 96 patients who underwent robotic colorectal surgery. Data analyzed included pertinent patient demographics, operative times (OR times), conversion rates, postoperative pathology, complications, length of hospital stay, 90-day readmission rates, 30-day mortality, and overall hospital costs. RESULTS: Two hundred and twenty-seven patients were included-laparoscopic (N = 131) and robotic (N = 96) colorectal surgeries. Mean age of patients in the laparoscopic versus robotic cohort was 70.9 vs 63.6 years, (p < 0.001). Around 62 % were operated on for malignant disease. Mean OR time was 113 min for laparoscopy and 109 min for robotics, p = 0.59. Conversion rates were comparable. Mean length of hospital stay (6.6 vs 5.7 days) and postoperative complications (3.2 vs 7 %) were comparable between the laparoscopic and robotic arms. Overall hospital charges were $114,853 for laparoscopy and $107,220 for robotics, and no significant difference was noted (p = 0.448, NS). CONCLUSION: Robotic colectomies were comparable to laparoscopic colectomies in terms of overall hospital charges and short-term clinical outcomes, including length of stay and conversion rates. Robotic surgery was favored for left-sided colectomy. With shorter learning curves and wider availability, robotic approach offers a safe and economically feasible minimally invasive platform for complex colorectal resections. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/27126626/Clinical_outcomes_and_cost_benefit_analysis_comparing_laparoscopic_and_robotic_colorectal_surgeries_ L2 - https://dx.doi.org/10.1007/s00464-016-4910-1 DB - PRIME DP - Unbound Medicine ER -