| Autor: |
José Tomás Larach, Julie Flynn, Michelle Tew, Diharah Fernando, Sameer Apte, Helen Mohan, Joseph Kong, Jacob J. McCormick, Satish K. Warrier, Alexander G. Heriot |
| Rok vydání: |
2023 |
| Popis: |
Aim: This study aims to compare the financial and clinical outcomes of robotic and laparoscopic proctectomy within a public healthcare system. Methods:Consecutive patients undergoing laparoscopic and robotic proctectomy between January 2017 and June 2020 in a public quaternary centre were included. Demographic characteristics, baseline clinical, tumour and operative variables, perioperative, histopathological outcomes and costs were compared between the laparoscopic and robotic groups. Simple linear regression and generalised linear model analyses with gamma distribution and log-link function were used to determine the impact of the surgical approach on overall costs. Results: During the study period, 113 patients underwent minimally invasive proctectomy. Of these, 81 (71.7%) underwent a robotic proctectomy. A taTME component was more often utilised in the laparoscopic group (34.4% versus 13.6%;P=0.003). Demographic and baseline clinical variables were otherwise similar between groups. A robotic approach was associated with a lower conversion rate (2.5% versus 21.8%;P=0.002) at the expense of longer operating times (284±83.4 versus 243±89.8 minutes;P=0.025). Regarding financial outcomes, robotic surgery was associated with increased theatre costs (A$23019±8235 versus A$15525±6382; PConclusion: Robotic proctectomy was associated with increased theatre costs but not with increased overall inpatient costs within a public healthcare setting. Conversion was less common for robotic proctectomy at the expense of increased operating time. Larger studies will be needed to confirm these findings and examine the cost-effectiveness of robotic proctectomy to further justify its penetration in the public healthcare system. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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