Objectives To evaluate and compare surgical parameters and costs associated with robotic and laparoscopic surgery for colorectal cancer over 5-years (2009-2014) in a single Italian centre. Methods From 2009 to 2014 data about laparoscopic (LAP) and robotic (ROB) assisted colorectal cancer procedures performed in General Surgery, University Hospital of Pisa were collected. Operating time and length of stay were evaluated as surgical parameters and costs included fixed and variable items. Amortised cost of the robot and laparoscopic instrument and amortised cost of robot maintenance per intervention were considered among fixed costs. Variable costs included costs of dispensable equipment, cost of operating room personnel per time and costs of length-of-stay. Over the 5-years period surgical parameters and costs associated with LAP and ROB were analysed using descriptive statistics and compared between groups by independent T-test and Mann-Whitney test. Generalized linear models were used to assess the independent effect of type of surgery and time. Results A total of 25 laparoscopic (LAP) and 50 robotic (ROB) procedures were evaluated. Overall median operating time was significantly higher in LAP (270 min vs 312.5 min, P=0.006) and regression analysis showed a borderline significant interaction effect between type of surgery and years (P=0.058) suggesting a significant reduction of operating time in ROB but not in LAP. Hospital-stay did not differ between groups (P=0.567). Overall mean costs associated to LAP varied between 8,612±2,733 Euros in 2009 to 10,827±5,038 Euros in 2013. For ROB mean costs were 12,966±1,115 Euros in 2010 to 11,933±1,753 Euros in 2014. Regression analysis outlined significant greater costs for ROB (P-value<0.001) without differences over time. Conclusions Robotic surgery for colorectal cancer carries out significant greater costs and operating time compared to laparoscopic surgery. There is weak evidence of improvement in the exploitation of ROB procedures without significant consequences on costs at present
Five-Years Experience of Robotic Vs Laparoscopic Colorectal Cancer Surgery in a Single Center: Surgical Parameters and Costs
MORELLI, LUCA;COBUCCIO, LUIGI;LORENZONI, VALENTINA;GUADAGNI, SIMONE;PALMERI, MATTEO;DI FRANCO, GREGORIO;GENNAI, ANDREA;D'ISIDORO, CRISTIANO;DI CANDIO, GIULIO;MOSCA, FRANCO;
2015-01-01
Abstract
Objectives To evaluate and compare surgical parameters and costs associated with robotic and laparoscopic surgery for colorectal cancer over 5-years (2009-2014) in a single Italian centre. Methods From 2009 to 2014 data about laparoscopic (LAP) and robotic (ROB) assisted colorectal cancer procedures performed in General Surgery, University Hospital of Pisa were collected. Operating time and length of stay were evaluated as surgical parameters and costs included fixed and variable items. Amortised cost of the robot and laparoscopic instrument and amortised cost of robot maintenance per intervention were considered among fixed costs. Variable costs included costs of dispensable equipment, cost of operating room personnel per time and costs of length-of-stay. Over the 5-years period surgical parameters and costs associated with LAP and ROB were analysed using descriptive statistics and compared between groups by independent T-test and Mann-Whitney test. Generalized linear models were used to assess the independent effect of type of surgery and time. Results A total of 25 laparoscopic (LAP) and 50 robotic (ROB) procedures were evaluated. Overall median operating time was significantly higher in LAP (270 min vs 312.5 min, P=0.006) and regression analysis showed a borderline significant interaction effect between type of surgery and years (P=0.058) suggesting a significant reduction of operating time in ROB but not in LAP. Hospital-stay did not differ between groups (P=0.567). Overall mean costs associated to LAP varied between 8,612±2,733 Euros in 2009 to 10,827±5,038 Euros in 2013. For ROB mean costs were 12,966±1,115 Euros in 2010 to 11,933±1,753 Euros in 2014. Regression analysis outlined significant greater costs for ROB (P-value<0.001) without differences over time. Conclusions Robotic surgery for colorectal cancer carries out significant greater costs and operating time compared to laparoscopic surgery. There is weak evidence of improvement in the exploitation of ROB procedures without significant consequences on costs at presentI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
