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Robotic-assisted gastrectomy compared with open resection: a comparative study of clinical outcomes and cost-effectiveness analysis

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Abstract

In the last decade, there have clearly been important changes in the surgical approach of gastric cancer treatment due to an increased interest in the minimally invasive surgical approach (MIS). The higher cost of robotic surgery procedures remains an important issue of debate. The objective of the study is to compare the main operative and clinical outcomes and to assess the incremental cost-effectiveness ratios (ICERs) of the two techniques. This is a prospective cost-effectiveness and clinical study when comparing the robotic gastrectomy (RG) technique with open gastrectomy (OG) in gastric cancer. Outcome parameters included surgical and post-operative costs, quality-adjusted life years (QALY) and incremental cost per QALY gained or the incremental cost-effectiveness ratio (ICER). The incremental utility was 0.038 QALYs and the estimated ICER for patients was dominated by robotic approach. The probability that the robotic approach was cost effective was 94.04% and 94.20%, respectively, at a WTP threshold of 20,000€ and 30,000€ per QALY gained. RG for gastric cancer represents a cost-effective procedure compared with the standard OG.

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Acknowledgements

We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

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Authors and Affiliations

  1. Sanchinarro University Hospital, General Surgery Department, San Pablo University, CEU, C/Oña nº 10, Madrid, 28050, Spain

    Riccardo Caruso, E. Vicente, J. Núñez-Alfonsel, V. Ferri, E. Diaz, I. Fabra, L. Malave, H. Duran, R. Isernia, A. D’Ovidio, E. Pinna, B. Ielpo & Y. Quijano

  2. Instituto de Validación de la Eficiencia Clínica (IVEc), Fundación de Investigación HM Hospitales, Madrid, Spain

    Riccardo Caruso, E. Vicente, J. Núñez-Alfonsel, V. Ferri, E. Diaz, I. Fabra, L. Malave, H. Duran, R. Isernia, A. D’Ovidio, E. Pinna, B. Ielpo & Y. Quijano

Authors
  1. Riccardo Caruso
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  2. E. Vicente
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  3. J. Núñez-Alfonsel
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  4. V. Ferri
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  5. E. Diaz
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  6. I. Fabra
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  7. L. Malave
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  8. H. Duran
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  9. R. Isernia
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  10. A. D’Ovidio
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  11. E. Pinna
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  12. B. Ielpo
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  13. Y. Quijano
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Contributions

EV and YQ proposed the study. RC performed the research and wrote the first draft. RC collected and analyzed the data. All authors contributed to the design and interpretation of the study and to further drafts. EV is the guarantor.

Corresponding author

Correspondence to Riccardo Caruso.

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Conflict of interest

Caruso R, Vicente E, Núñez-Alfonsel J, Ferri V, Diaz E, Fabra I, Malave L, Duran H, Isernia R, D’Ovidio A, Pinna E, Ielpo B, Quijano Y declare that they have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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Caruso, R., Vicente, E., Núñez-Alfonsel, J. et al. Robotic-assisted gastrectomy compared with open resection: a comparative study of clinical outcomes and cost-effectiveness analysis. J Robotic Surg 14, 627–632 (2020). https://doi.org/10.1007/s11701-019-01033-x

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  • DOI: https://doi.org/10.1007/s11701-019-01033-x

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