Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study
Background After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS)...
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| Veröffentlicht in: | World journal of surgery 2017-02, Vol.41 (2), p.516-524 |
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| creator | Salloum, Chady Lim, Chetana Lahat, Eylon Gavara, Concepcion Gomez I. Levesque, Eric Compagnon, Philippe Azoulay, Daniel |
| description | Background
After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS) and robotic (R-LLS) LLS.
Methods
All consecutive patients who underwent L-LLS or R-LLS from 1997 to 2014 were analyzed. Short-term and economic outcomes were compared between the two groups using a propensity score matching (PSM).
Results
Ninety-six consecutive cases of LLS were performed using the laparoscopic (80 cases; 83 %) or robotic (16 cases; 17 %) approach. The two groups were similar for operative and surgical outcomes. Operation time was similar in the R-LLS compared to the L-LLS group (190 vs. 162 min;
p
= 0.10). Perioperative costs were higher (1457 € vs. 576 €;
p
|
| doi_str_mv | 10.1007/s00268-016-3736-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1868327746</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835413616</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5211-5bb3834590d83f71cbe82d1994a48918b4a444b4e9002bf7537f41a058cc5dc53</originalsourceid><addsrcrecordid>eNqNkd2K1TAUhYMoznH0AbyRgDfeVLOTtEm9O3Nw_OHIiPXnMqRpOtOhbWqSIn0OX9jUjiKC6E122HxrsVkLoYdAngIh4lkghBYyI1BkTLAio7fQDjijGWWU3UY7wgqe_sBO0L0QrgkBUZDiLjqhQnBGBOzQt_eudrEz2T6ELkTb4E_Whzngo560d8G4qTP4aNuYNtF63ePKmti5Mb1uWJ7j_aj7JWmxa3E1-8vOJOZijsYNNmA9NvjgQgy4XrDG77yb7Bi6uODKOG_xWx3NlV2ZK-cjruLcLPfRnVb3wT64mafo4_mLD4dX2fHi5evD_piZnAJkeV0zyXhekkayVoCpraQNlCXXXJYg6zQ5r7ktU0x1K3ImWg6a5NKYvDE5O0VPNt_Juy-zDVENXTC27_Vo3RwUyEKyNariP1CWc2AFrOjjP9BrN_sU0g_DnKbbhUgUbJRJIQdvWzX5btB-UUDUWq7aylWpXLWWq2jSPLpxnuvBNr8UP9tMQLkBX7veLv92VJ_fVGfnRAJftXTThiQbL63_7ey_XvQdfwvABg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1865252177</pqid></control><display><type>article</type><title>Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>SpringerLink Journals - AutoHoldings</source><creator>Salloum, Chady ; Lim, Chetana ; Lahat, Eylon ; Gavara, Concepcion Gomez I. ; Levesque, Eric ; Compagnon, Philippe ; Azoulay, Daniel</creator><creatorcontrib>Salloum, Chady ; Lim, Chetana ; Lahat, Eylon ; Gavara, Concepcion Gomez I. ; Levesque, Eric ; Compagnon, Philippe ; Azoulay, Daniel</creatorcontrib><description>Background
After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS) and robotic (R-LLS) LLS.
Methods
All consecutive patients who underwent L-LLS or R-LLS from 1997 to 2014 were analyzed. Short-term and economic outcomes were compared between the two groups using a propensity score matching (PSM).
Results
Ninety-six consecutive cases of LLS were performed using the laparoscopic (80 cases; 83 %) or robotic (16 cases; 17 %) approach. The two groups were similar for operative and surgical outcomes. Operation time was similar in the R-LLS compared to the L-LLS group (190 vs. 162 min;
p
= 0.10). Perioperative costs were higher (1457 € vs. 576 €;
p
< 0.0001) in the R-LLS group than in the L-LLS group; however, postoperative costs were similar between the two groups (4065 € in the R-LLS group vs. 5459 € in the L-LLS group;
p
= 0.30). Total costs were similar between the two groups (5522 € in the R-LLS group vs. 6035€ in the L-LLS group;
p
= 0.70). The PSM included 14 patients for each group. Surgical and economic outcomes remained similar after PSM, except for total operating time which was significantly longer in the R-LLS group than in the L-LLS group.
Conclusions
Even if feasible and safe, the robotic approach does not seem so far to offer additional benefit in terms of intra- and postoperative outcomes over the laparoscopic approach in patients requiring LLS. Total costs associated with the R-LLS group are not greater than that associated with the L-LLS group, which is the standard of care so far.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-016-3736-2</identifier><identifier>PMID: 27743071</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Cardiac Surgery ; Female ; General Surgery ; Health Care Costs ; Hepatectomy - economics ; Hepatectomy - methods ; Humans ; Laparoscopic Liver Resection ; Laparoscopy - economics ; Liver Resection ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Operative Time ; Original Scientific Report ; Perioperative Care - economics ; Propensity Score ; Propensity Score Match ; Retrospective Studies ; Robotic Approach ; Robotic Group ; Robotic Surgical Procedures - economics ; Surgery ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery</subject><ispartof>World journal of surgery, 2017-02, Vol.41 (2), p.516-524</ispartof><rights>Société Internationale de Chirurgie 2016</rights><rights>2017 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5211-5bb3834590d83f71cbe82d1994a48918b4a444b4e9002bf7537f41a058cc5dc53</citedby><cites>FETCH-LOGICAL-c5211-5bb3834590d83f71cbe82d1994a48918b4a444b4e9002bf7537f41a058cc5dc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-016-3736-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-016-3736-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,41488,42557,45574,45575,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27743071$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Salloum, Chady</creatorcontrib><creatorcontrib>Lim, Chetana</creatorcontrib><creatorcontrib>Lahat, Eylon</creatorcontrib><creatorcontrib>Gavara, Concepcion Gomez I.</creatorcontrib><creatorcontrib>Levesque, Eric</creatorcontrib><creatorcontrib>Compagnon, Philippe</creatorcontrib><creatorcontrib>Azoulay, Daniel</creatorcontrib><title>Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS) and robotic (R-LLS) LLS.
Methods
All consecutive patients who underwent L-LLS or R-LLS from 1997 to 2014 were analyzed. Short-term and economic outcomes were compared between the two groups using a propensity score matching (PSM).
Results
Ninety-six consecutive cases of LLS were performed using the laparoscopic (80 cases; 83 %) or robotic (16 cases; 17 %) approach. The two groups were similar for operative and surgical outcomes. Operation time was similar in the R-LLS compared to the L-LLS group (190 vs. 162 min;
p
= 0.10). Perioperative costs were higher (1457 € vs. 576 €;
p
< 0.0001) in the R-LLS group than in the L-LLS group; however, postoperative costs were similar between the two groups (4065 € in the R-LLS group vs. 5459 € in the L-LLS group;
p
= 0.30). Total costs were similar between the two groups (5522 € in the R-LLS group vs. 6035€ in the L-LLS group;
p
= 0.70). The PSM included 14 patients for each group. Surgical and economic outcomes remained similar after PSM, except for total operating time which was significantly longer in the R-LLS group than in the L-LLS group.
Conclusions
Even if feasible and safe, the robotic approach does not seem so far to offer additional benefit in terms of intra- and postoperative outcomes over the laparoscopic approach in patients requiring LLS. Total costs associated with the R-LLS group are not greater than that associated with the L-LLS group, which is the standard of care so far.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiac Surgery</subject><subject>Female</subject><subject>General Surgery</subject><subject>Health Care Costs</subject><subject>Hepatectomy - economics</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Laparoscopic Liver Resection</subject><subject>Laparoscopy - economics</subject><subject>Liver Resection</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Original Scientific Report</subject><subject>Perioperative Care - economics</subject><subject>Propensity Score</subject><subject>Propensity Score Match</subject><subject>Retrospective Studies</subject><subject>Robotic Approach</subject><subject>Robotic Group</subject><subject>Robotic Surgical Procedures - economics</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkd2K1TAUhYMoznH0AbyRgDfeVLOTtEm9O3Nw_OHIiPXnMqRpOtOhbWqSIn0OX9jUjiKC6E122HxrsVkLoYdAngIh4lkghBYyI1BkTLAio7fQDjijGWWU3UY7wgqe_sBO0L0QrgkBUZDiLjqhQnBGBOzQt_eudrEz2T6ELkTb4E_Whzngo560d8G4qTP4aNuYNtF63ePKmti5Mb1uWJ7j_aj7JWmxa3E1-8vOJOZijsYNNmA9NvjgQgy4XrDG77yb7Bi6uODKOG_xWx3NlV2ZK-cjruLcLPfRnVb3wT64mafo4_mLD4dX2fHi5evD_piZnAJkeV0zyXhekkayVoCpraQNlCXXXJYg6zQ5r7ktU0x1K3ImWg6a5NKYvDE5O0VPNt_Juy-zDVENXTC27_Vo3RwUyEKyNariP1CWc2AFrOjjP9BrN_sU0g_DnKbbhUgUbJRJIQdvWzX5btB-UUDUWq7aylWpXLWWq2jSPLpxnuvBNr8UP9tMQLkBX7veLv92VJ_fVGfnRAJftXTThiQbL63_7ey_XvQdfwvABg</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Salloum, Chady</creator><creator>Lim, Chetana</creator><creator>Lahat, Eylon</creator><creator>Gavara, Concepcion Gomez I.</creator><creator>Levesque, Eric</creator><creator>Compagnon, Philippe</creator><creator>Azoulay, Daniel</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study</title><author>Salloum, Chady ; Lim, Chetana ; Lahat, Eylon ; Gavara, Concepcion Gomez I. ; Levesque, Eric ; Compagnon, Philippe ; Azoulay, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5211-5bb3834590d83f71cbe82d1994a48918b4a444b4e9002bf7537f41a058cc5dc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiac Surgery</topic><topic>Female</topic><topic>General Surgery</topic><topic>Health Care Costs</topic><topic>Hepatectomy - economics</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Laparoscopic Liver Resection</topic><topic>Laparoscopy - economics</topic><topic>Liver Resection</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Original Scientific Report</topic><topic>Perioperative Care - economics</topic><topic>Propensity Score</topic><topic>Propensity Score Match</topic><topic>Retrospective Studies</topic><topic>Robotic Approach</topic><topic>Robotic Group</topic><topic>Robotic Surgical Procedures - economics</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Salloum, Chady</creatorcontrib><creatorcontrib>Lim, Chetana</creatorcontrib><creatorcontrib>Lahat, Eylon</creatorcontrib><creatorcontrib>Gavara, Concepcion Gomez I.</creatorcontrib><creatorcontrib>Levesque, Eric</creatorcontrib><creatorcontrib>Compagnon, Philippe</creatorcontrib><creatorcontrib>Azoulay, Daniel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</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>Technology Research Database</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>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</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><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Salloum, Chady</au><au>Lim, Chetana</au><au>Lahat, Eylon</au><au>Gavara, Concepcion Gomez I.</au><au>Levesque, Eric</au><au>Compagnon, Philippe</au><au>Azoulay, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2017-02</date><risdate>2017</risdate><volume>41</volume><issue>2</issue><spage>516</spage><epage>524</epage><pages>516-524</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS) and robotic (R-LLS) LLS.
Methods
All consecutive patients who underwent L-LLS or R-LLS from 1997 to 2014 were analyzed. Short-term and economic outcomes were compared between the two groups using a propensity score matching (PSM).
Results
Ninety-six consecutive cases of LLS were performed using the laparoscopic (80 cases; 83 %) or robotic (16 cases; 17 %) approach. The two groups were similar for operative and surgical outcomes. Operation time was similar in the R-LLS compared to the L-LLS group (190 vs. 162 min;
p
= 0.10). Perioperative costs were higher (1457 € vs. 576 €;
p
< 0.0001) in the R-LLS group than in the L-LLS group; however, postoperative costs were similar between the two groups (4065 € in the R-LLS group vs. 5459 € in the L-LLS group;
p
= 0.30). Total costs were similar between the two groups (5522 € in the R-LLS group vs. 6035€ in the L-LLS group;
p
= 0.70). The PSM included 14 patients for each group. Surgical and economic outcomes remained similar after PSM, except for total operating time which was significantly longer in the R-LLS group than in the L-LLS group.
Conclusions
Even if feasible and safe, the robotic approach does not seem so far to offer additional benefit in terms of intra- and postoperative outcomes over the laparoscopic approach in patients requiring LLS. Total costs associated with the R-LLS group are not greater than that associated with the L-LLS group, which is the standard of care so far.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>27743071</pmid><doi>10.1007/s00268-016-3736-2</doi><tpages>9</tpages></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adult Aged Cardiac Surgery Female General Surgery Health Care Costs Hepatectomy - economics Hepatectomy - methods Humans Laparoscopic Liver Resection Laparoscopy - economics Liver Resection Male Medicine Medicine & Public Health Middle Aged Operative Time Original Scientific Report Perioperative Care - economics Propensity Score Propensity Score Match Retrospective Studies Robotic Approach Robotic Group Robotic Surgical Procedures - economics Surgery Thoracic Surgery Treatment Outcome Vascular Surgery |
| title | Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study |
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