Valentina Ferri1, Yolanda Quijano2, Javier Nuñez3, Riccardo Caruso2, Hipolito Duran2, Eduardo Diaz2, Isabel Fabra2, Luisi Malave2, Roberta Isernia4, Angelo d'Ovidio5, Ruben Agresott2, Patricio Gomez2, Rigoberto Isojo2, Emilio Vicente2. 1. Division of General Surgery, HM-Sanchinarro University Hospital, San Pablo University, calle oña 10, Madrid, Spain. valenpeglio@gmail.com. 2. Division of General Surgery, HM-Sanchinarro University Hospital, San Pablo University, calle oña 10, Madrid, Spain. 3. IVEC (Instituto de Validación de la Eficiencia Clínica), Fundación de Investigación HM Hospitales, Madrid, Spain. 4. Division of General Surgery, Faculty of Medicine and Surgery, University of Bari, Bari, Italy. 5. Division of General Surgery, Faculty of Medicine and Surgery, University of Pavia, Pavia, Italy.
Abstract
AIM: The aim of this study is to compare clinical and oncological outcomes of robot-assisted right colectomy with those of conventional laparoscopy-assisted right colectomy, reporting for the first time in literature, a cost-effectiveness analysis. METHODS: This is a case-matched prospective non-randomized study conducted from October 2013 to October 2017 at Sanchinarro University Hospital, Madrid. Patients with right-sided colonic adenocarcinoma or adenoma, not suitable endoscopic resection were treated with robot-assisted right colectomy and a propensity score-matched (1:1) was used to balance preoperative characteristics of a laparoscopic control group. Perioperative, postoperative, long-term oncological results and costs were analysed, and quality-adjusted life years (QALY), and the cost-effectiveness ratio (ICER) were calculated. The primary end point was to compare the cost-effectiveness differences between both groups. A willingness-to-pay of 20,000 and 30,000 per QALY was used as a threshold to recognize which treatment was most cost effective. RESULTS: Thirty-five robot-assisted right colectomies were included and a group of 35 laparoscopy-assisted right colectomy was selected. Compared with the laparoscopic group, the robotic group was associated with longer operation times (243 min vs. 179 min, p < 0.001). No significant difference was observed in terms of total costs between the robotic and laparoscopic groups (9455.14 vs 8227.50 respectively, p = 0.21). At a willingness-to-pay threshold of 20,000 and 30,000, there was a 78.78-95.04% probability that the robotic group was cost effective relative to laparoscopic group. CONCLUSION: Robot-assisted right colectomy is a safe and feasible technique and is a cost-effective procedure.
AIM: The aim of this study is to compare clinical and oncological outcomes of robot-assisted right colectomy with those of conventional laparoscopy-assisted right colectomy, reporting for the first time in literature, a cost-effectiveness analysis. METHODS: This is a case-matched prospective non-randomized study conducted from October 2013 to October 2017 at Sanchinarro University Hospital, Madrid. Patients with right-sided colonic adenocarcinoma or adenoma, not suitable endoscopic resection were treated with robot-assisted right colectomy and a propensity score-matched (1:1) was used to balance preoperative characteristics of a laparoscopic control group. Perioperative, postoperative, long-term oncological results and costs were analysed, and quality-adjusted life years (QALY), and the cost-effectiveness ratio (ICER) were calculated. The primary end point was to compare the cost-effectiveness differences between both groups. A willingness-to-pay of 20,000 and 30,000 per QALY was used as a threshold to recognize which treatment was most cost effective. RESULTS: Thirty-five robot-assisted right colectomies were included and a group of 35 laparoscopy-assisted right colectomy was selected. Compared with the laparoscopic group, the robotic group was associated with longer operation times (243 min vs. 179 min, p < 0.001). No significant difference was observed in terms of total costs between the robotic and laparoscopic groups (9455.14 vs 8227.50 respectively, p = 0.21). At a willingness-to-pay threshold of 20,000 and 30,000, there was a 78.78-95.04% probability that the robotic group was cost effective relative to laparoscopic group. CONCLUSION: Robot-assisted right colectomy is a safe and feasible technique and is a cost-effective procedure.
Entities:
Keywords:
Cost analysis; Cost-effectiveness analysis; Oncological outcomes; Robotic right colectomy
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