Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis
Background Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP). Methods From 2011 until 2016, all consecutiv...
Gespeichert in:
| Veröffentlicht in: | Surgical endoscopy 2018-08, Vol.32 (8), p.3562-3569 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3569 |
|---|---|
| container_issue | 8 |
| container_start_page | 3562 |
| container_title | Surgical endoscopy |
| container_volume | 32 |
| creator | Souche, Regis Herrero, Astrid Bourel, Guillaume Chauvat, John Pirlet, Isabelle Guillon, Françoise Nocca, David Borie, Frederic Mercier, Gregoire Fabre, Jean-Michel |
| description | Background
Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP).
Methods
From 2011 until 2016, all consecutive patients underwent minimally invasive DP were included and data were prospectively collected. Patients were assigned in two groups, RDP and LDP, according to the availability of the Da Vinci® Surgical System for our Surgical Unit.
Results
A minimally invasive DP was performed in 38 patients with a median age of 61 years old (44–83 years old) and a BMI of 26 kg/m
2
(20–31 kg/m
2
). RDP group (
n
= 15) and LDP group (
n
= 23) were comparable concerning demographic data, BMI, ASA score, comorbidities, malignant lesions, lesion size, and indication of spleen preservation. Median operative time was longer in RDP (207 min) compared to LDP (187 min) (
p
= 0.047). Conversion rate, spleen preservation failure, and perioperative transfusion rates were nil in both groups. Pancreatic fistula was diagnosed in 40 and 43% (
p
= 0.832) of patients and was grade A in 83 and 80% (
p
= 1.000) in RDP and LDP groups, respectively. Median postoperative hospital stay was similar in both groups (RDP: 8 days vs. LDP: 9 days,
p
= 0.310). Major complication occurred in 7% in RDP group and 13% in LDP group (
p
= 1.000). Ninety-days mortality was nil in both groups. No difference was found concerning R0 resection rate and median number of retrieved lymph nodes. Total cost of RDP was higher than LDP (13611 vs. 12509 €,
p
|
| doi_str_mv | 10.1007/s00464-018-6080-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_02292389v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1993997201</sourcerecordid><originalsourceid>FETCH-LOGICAL-c406t-aa2be84bbd35d60171daf745a04e4d5c4463bd46c6805f24a494966a726076613</originalsourceid><addsrcrecordid>eNp1kUGL1TAUhYMoznP0B7iRgBtdRJM0TRt3w-A4wgNBdB1u09uZDn1NzW0fvp0_3ZSOgwiuAiffPck9h7GXSr5TUlbvSUpjjZCqFlbWUrhHbKdMoYXWqn7MdtIVUujKmTP2jOhOZtyp8ik7065wtirNjv36Gps494EfMdFCfIAJUqQQp6y1Pc0w8AnGkBBmDHM8nD5w4FcJx3DLp0xOWe2PyKkfbwYUAccZE8efE6Y-Q8hhbHmINAvsuo0dkSjLMJyop-fsSQcD4Yv785x9v_r47fJa7L98-nx5sRfBSDsLAN1gbZqmLcrWSlWpFrrKlCANmrYMxtiiaY0NtpZlpw0YZ5y1UGkrK2tVcc7ebr63MPgp9QdIJx-h99cXe79qUmuni9odV_bNxuYFfyxIsz_0FHAYYMS4kFcu5-cqLVf09T_oXVxS3m2jbGlz_plSGxVyYpSwe_iBkn6t0m9V-lylX6v068yre-elOWD7MPGnuwzoDaB8Nd5g-uvp_7r-Bnarqjk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1993656279</pqid></control><display><type>article</type><title>Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Souche, Regis ; Herrero, Astrid ; Bourel, Guillaume ; Chauvat, John ; Pirlet, Isabelle ; Guillon, Françoise ; Nocca, David ; Borie, Frederic ; Mercier, Gregoire ; Fabre, Jean-Michel</creator><creatorcontrib>Souche, Regis ; Herrero, Astrid ; Bourel, Guillaume ; Chauvat, John ; Pirlet, Isabelle ; Guillon, Françoise ; Nocca, David ; Borie, Frederic ; Mercier, Gregoire ; Fabre, Jean-Michel</creatorcontrib><description>Background
Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP).
Methods
From 2011 until 2016, all consecutive patients underwent minimally invasive DP were included and data were prospectively collected. Patients were assigned in two groups, RDP and LDP, according to the availability of the Da Vinci® Surgical System for our Surgical Unit.
Results
A minimally invasive DP was performed in 38 patients with a median age of 61 years old (44–83 years old) and a BMI of 26 kg/m
2
(20–31 kg/m
2
). RDP group (
n
= 15) and LDP group (
n
= 23) were comparable concerning demographic data, BMI, ASA score, comorbidities, malignant lesions, lesion size, and indication of spleen preservation. Median operative time was longer in RDP (207 min) compared to LDP (187 min) (
p
= 0.047). Conversion rate, spleen preservation failure, and perioperative transfusion rates were nil in both groups. Pancreatic fistula was diagnosed in 40 and 43% (
p
= 0.832) of patients and was grade A in 83 and 80% (
p
= 1.000) in RDP and LDP groups, respectively. Median postoperative hospital stay was similar in both groups (RDP: 8 days vs. LDP: 9 days,
p
= 0.310). Major complication occurred in 7% in RDP group and 13% in LDP group (
p
= 1.000). Ninety-days mortality was nil in both groups. No difference was found concerning R0 resection rate and median number of retrieved lymph nodes. Total cost of RDP was higher than LDP (13611 vs. 12509 €,
p
< 0.001). The difference between mean hospital incomes and costs was negative in RDP group contrary to LDP group (− 1269 vs. 1395 €,
p
= 0.040).
Conclusion
Short-term results of RDP seem to be similar to LDP but the high cost of RDP makes this approach not cost-effective actually.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6080-9</identifier><identifier>PMID: 29396754</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Cancer ; Cost analysis ; Gastroenterology ; Gynecology ; Hepatology ; Human health and pathology ; Laparoscopy ; Life Sciences ; Medicine ; Medicine & Public Health ; Pancreatectomy ; Proctology ; Robotics ; Surgery</subject><ispartof>Surgical endoscopy, 2018-08, Vol.32 (8), p.3562-3569</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-aa2be84bbd35d60171daf745a04e4d5c4463bd46c6805f24a494966a726076613</citedby><cites>FETCH-LOGICAL-c406t-aa2be84bbd35d60171daf745a04e4d5c4463bd46c6805f24a494966a726076613</cites><orcidid>0000-0002-1961-5844 ; 0000-0001-5531-4515</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6080-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6080-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29396754$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.umontpellier.fr/hal-02292389$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Souche, Regis</creatorcontrib><creatorcontrib>Herrero, Astrid</creatorcontrib><creatorcontrib>Bourel, Guillaume</creatorcontrib><creatorcontrib>Chauvat, John</creatorcontrib><creatorcontrib>Pirlet, Isabelle</creatorcontrib><creatorcontrib>Guillon, Françoise</creatorcontrib><creatorcontrib>Nocca, David</creatorcontrib><creatorcontrib>Borie, Frederic</creatorcontrib><creatorcontrib>Mercier, Gregoire</creatorcontrib><creatorcontrib>Fabre, Jean-Michel</creatorcontrib><title>Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP).
Methods
From 2011 until 2016, all consecutive patients underwent minimally invasive DP were included and data were prospectively collected. Patients were assigned in two groups, RDP and LDP, according to the availability of the Da Vinci® Surgical System for our Surgical Unit.
Results
A minimally invasive DP was performed in 38 patients with a median age of 61 years old (44–83 years old) and a BMI of 26 kg/m
2
(20–31 kg/m
2
). RDP group (
n
= 15) and LDP group (
n
= 23) were comparable concerning demographic data, BMI, ASA score, comorbidities, malignant lesions, lesion size, and indication of spleen preservation. Median operative time was longer in RDP (207 min) compared to LDP (187 min) (
p
= 0.047). Conversion rate, spleen preservation failure, and perioperative transfusion rates were nil in both groups. Pancreatic fistula was diagnosed in 40 and 43% (
p
= 0.832) of patients and was grade A in 83 and 80% (
p
= 1.000) in RDP and LDP groups, respectively. Median postoperative hospital stay was similar in both groups (RDP: 8 days vs. LDP: 9 days,
p
= 0.310). Major complication occurred in 7% in RDP group and 13% in LDP group (
p
= 1.000). Ninety-days mortality was nil in both groups. No difference was found concerning R0 resection rate and median number of retrieved lymph nodes. Total cost of RDP was higher than LDP (13611 vs. 12509 €,
p
< 0.001). The difference between mean hospital incomes and costs was negative in RDP group contrary to LDP group (− 1269 vs. 1395 €,
p
= 0.040).
Conclusion
Short-term results of RDP seem to be similar to LDP but the high cost of RDP makes this approach not cost-effective actually.</description><subject>Abdominal Surgery</subject><subject>Cancer</subject><subject>Cost analysis</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Human health and pathology</subject><subject>Laparoscopy</subject><subject>Life Sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pancreatectomy</subject><subject>Proctology</subject><subject>Robotics</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUGL1TAUhYMoznP0B7iRgBtdRJM0TRt3w-A4wgNBdB1u09uZDn1NzW0fvp0_3ZSOgwiuAiffPck9h7GXSr5TUlbvSUpjjZCqFlbWUrhHbKdMoYXWqn7MdtIVUujKmTP2jOhOZtyp8ik7065wtirNjv36Gps494EfMdFCfIAJUqQQp6y1Pc0w8AnGkBBmDHM8nD5w4FcJx3DLp0xOWe2PyKkfbwYUAccZE8efE6Y-Q8hhbHmINAvsuo0dkSjLMJyop-fsSQcD4Yv785x9v_r47fJa7L98-nx5sRfBSDsLAN1gbZqmLcrWSlWpFrrKlCANmrYMxtiiaY0NtpZlpw0YZ5y1UGkrK2tVcc7ebr63MPgp9QdIJx-h99cXe79qUmuni9odV_bNxuYFfyxIsz_0FHAYYMS4kFcu5-cqLVf09T_oXVxS3m2jbGlz_plSGxVyYpSwe_iBkn6t0m9V-lylX6v068yre-elOWD7MPGnuwzoDaB8Nd5g-uvp_7r-Bnarqjk</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Souche, Regis</creator><creator>Herrero, Astrid</creator><creator>Bourel, Guillaume</creator><creator>Chauvat, John</creator><creator>Pirlet, Isabelle</creator><creator>Guillon, Françoise</creator><creator>Nocca, David</creator><creator>Borie, Frederic</creator><creator>Mercier, Gregoire</creator><creator>Fabre, Jean-Michel</creator><general>Springer US</general><general>Springer Nature B.V</general><general>Springer Verlag (Germany)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-1961-5844</orcidid><orcidid>https://orcid.org/0000-0001-5531-4515</orcidid></search><sort><creationdate>20180801</creationdate><title>Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis</title><author>Souche, Regis ; Herrero, Astrid ; Bourel, Guillaume ; Chauvat, John ; Pirlet, Isabelle ; Guillon, Françoise ; Nocca, David ; Borie, Frederic ; Mercier, Gregoire ; Fabre, Jean-Michel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-aa2be84bbd35d60171daf745a04e4d5c4463bd46c6805f24a494966a726076613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Cancer</topic><topic>Cost analysis</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Human health and pathology</topic><topic>Laparoscopy</topic><topic>Life Sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pancreatectomy</topic><topic>Proctology</topic><topic>Robotics</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Souche, Regis</creatorcontrib><creatorcontrib>Herrero, Astrid</creatorcontrib><creatorcontrib>Bourel, Guillaume</creatorcontrib><creatorcontrib>Chauvat, John</creatorcontrib><creatorcontrib>Pirlet, Isabelle</creatorcontrib><creatorcontrib>Guillon, Françoise</creatorcontrib><creatorcontrib>Nocca, David</creatorcontrib><creatorcontrib>Borie, Frederic</creatorcontrib><creatorcontrib>Mercier, Gregoire</creatorcontrib><creatorcontrib>Fabre, Jean-Michel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Souche, Regis</au><au>Herrero, Astrid</au><au>Bourel, Guillaume</au><au>Chauvat, John</au><au>Pirlet, Isabelle</au><au>Guillon, Françoise</au><au>Nocca, David</au><au>Borie, Frederic</au><au>Mercier, Gregoire</au><au>Fabre, Jean-Michel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>32</volume><issue>8</issue><spage>3562</spage><epage>3569</epage><pages>3562-3569</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Benefits and cost-effectiveness of robotic approach for distal pancreatectomy (DP) remain debated. In this prospective study, we aim to compare the short-term results and real costs of robotic (RDP) and laparoscopic distal pancreatectomy (LDP).
Methods
From 2011 until 2016, all consecutive patients underwent minimally invasive DP were included and data were prospectively collected. Patients were assigned in two groups, RDP and LDP, according to the availability of the Da Vinci® Surgical System for our Surgical Unit.
Results
A minimally invasive DP was performed in 38 patients with a median age of 61 years old (44–83 years old) and a BMI of 26 kg/m
2
(20–31 kg/m
2
). RDP group (
n
= 15) and LDP group (
n
= 23) were comparable concerning demographic data, BMI, ASA score, comorbidities, malignant lesions, lesion size, and indication of spleen preservation. Median operative time was longer in RDP (207 min) compared to LDP (187 min) (
p
= 0.047). Conversion rate, spleen preservation failure, and perioperative transfusion rates were nil in both groups. Pancreatic fistula was diagnosed in 40 and 43% (
p
= 0.832) of patients and was grade A in 83 and 80% (
p
= 1.000) in RDP and LDP groups, respectively. Median postoperative hospital stay was similar in both groups (RDP: 8 days vs. LDP: 9 days,
p
= 0.310). Major complication occurred in 7% in RDP group and 13% in LDP group (
p
= 1.000). Ninety-days mortality was nil in both groups. No difference was found concerning R0 resection rate and median number of retrieved lymph nodes. Total cost of RDP was higher than LDP (13611 vs. 12509 €,
p
< 0.001). The difference between mean hospital incomes and costs was negative in RDP group contrary to LDP group (− 1269 vs. 1395 €,
p
= 0.040).
Conclusion
Short-term results of RDP seem to be similar to LDP but the high cost of RDP makes this approach not cost-effective actually.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29396754</pmid><doi>10.1007/s00464-018-6080-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1961-5844</orcidid><orcidid>https://orcid.org/0000-0001-5531-4515</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2018-08, Vol.32 (8), p.3562-3569 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_02292389v1 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Cancer Cost analysis Gastroenterology Gynecology Hepatology Human health and pathology Laparoscopy Life Sciences Medicine Medicine & Public Health Pancreatectomy Proctology Robotics Surgery |
| title | Robotic versus laparoscopic distal pancreatectomy: a French prospective single-center experience and cost-effectiveness analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-11T02%3A23%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Robotic%20versus%20laparoscopic%20distal%20pancreatectomy:%20a%20French%20prospective%20single-center%20experience%20and%20cost-effectiveness%20analysis&rft.jtitle=Surgical%20endoscopy&rft.au=Souche,%20Regis&rft.date=2018-08-01&rft.volume=32&rft.issue=8&rft.spage=3562&rft.epage=3569&rft.pages=3562-3569&rft.issn=0930-2794&rft.eissn=1432-2218&rft_id=info:doi/10.1007/s00464-018-6080-9&rft_dat=%3Cproquest_hal_p%3E1993997201%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1993656279&rft_id=info:pmid/29396754&rfr_iscdi=true |