Costs of robot-assisted vs. open approaches for 5 major cancers. in Journal of robotic surgery / J Robot Surg. 2025 May 7;19(1):205. doi: 10.1007/s11701-025-02350-0.
2025
AOU Novara
AOU Novara
Tipo pubblicazione
Journal Article
Autori/Collaboratori (24)Vedi tutti...
Di Bello F
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada. fran.dibello12@gmail.com.
Rodriguez Peñaranda N
Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Via Pansini, 80131, Naples, Italy. fran.dibello12@gmail.com.
Marmiroli A
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.
et alii...
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada. fran.dibello12@gmail.com.
Rodriguez Peñaranda N
Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Via Pansini, 80131, Naples, Italy. fran.dibello12@gmail.com.
Marmiroli A
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.
et alii...
Abstract
To test for differences in total hospital cost (THC) between robot-assisted vs. open major cancer surgeries, colectomy, esophagectomy, radical hysterectomy, lung resection and pancreatectomy. Within the National Inpatient Sample (2016-2019), we identified all robot-assisted vs. open procedures for the above stated surgeries. Multivariable Poisson regression models were fitted. Of all surgeries, 6830 (14%) were robot-assisted colectomies, 333 (7%) esophagectomies, 5985 (24%) radical hysterectomies, 6500 (21%) lung resections and 449 (4%) pancreatectomies. Relative to open surgery, robot-assisted esophagectomy (181,462 vs. 96,195 $, ??=?85,267 $), pancreatectomy (123,872 vs. 95,707 $, ??=?28,168 $), lung resection (93,910 vs. 80,770 $, ??=?13,140 $) and colectomy (82,898 vs. 71,279 $, ??=?11,619 $) were associated with higher THC (all p?0.001), except for radical hysterectomy (63,793 vs. 62,558 $, p?=?0.8). After multivariable adjustment for patient and hospital characteristics, robot-assisted esophagectomy (risk ratio [RR]: 1.40), robot-assisted pancreatectomy (RR: 1.24), robot-assisted colectomy (RR: 1.20), robot-assisted lung resection (RR: 1.11) as well as robot-assisted radical hysterectomy (RR: 1.10) independently predicted higher THC (all p?0.001). For the five examined procedures, THC are invariably higher when the robot-assisted approach is used. This THC disadvantage of the robot-assisted approach requires a careful consideration to the other benefits of robotic-assisted surgery, such as shorter convalescence and earlier return to regular activities, that could not be addressed in the current analysis.
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PMID : 40332686
DOI : 10.1007/s11701-025-02350-0
Keywords
Humans; Robotic Surgical Procedures/economics/methods; Female; Middle Aged; Male; Aged; Neoplasms/surgery/economics; Hysterectomy/economics/methods; Hospital Costs/statistics & numerical data; Pancreatectomy/economics/methods; Colectomy/economics/methods; Esophagectomy/economics/methods; Pneumonectomy/economics/methods; Complications; NIS; Surgery;