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Robotic versus laparoscopic surgery for rectal cancer: a comparative study of clinical outcomes and costs

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The costs involved in performing robotic surgery present a critical issue which has not been well addressed yet. The aims of this study are to compare the clinical outcomes and cost differences of robotic versus laparoscopic surgery in the treatment of rectal cancer and to conduct a literature review of the cost analysis.

Methods

This is an observational, comparative study whereby data were abstracted from a retrospective database of patients who underwent laparoscopic and robotic rectal resection from October 2010 to March 2017, at Sanchinarro University Hospital, Madrid. An independent company performed the financial analysis, and fixed costs were excluded.

Results

A total of 86 robotic and 112 laparoscopic rectal resections were included. The mean operative time was significantly lower in the laparoscopic approach (336 versus 283 min; p = 0.001). The main pre-operative data, overall morbidity, hospital stay and oncological outcomes were similar in both groups, except for the readmission rate (robotic: 5.8%, laparoscopic: 11.6%; p = 0.001). The mean operative costs were higher for robotic surgery (4285.16 versus 3506.11€; p = 0.04); however, the mean overall costs were similar (7279.31€ for robotic and 6879.8€ for the laparoscopic approach; p = 0.44). We found four studies reporting costs, three comparing robotic versus laparoscopy costs, with all of them reporting a higher overall cost for the robotic rectal resection.

Conclusion

Robotic rectal resection has similar clinical outcomes to that of the conventional laparoscopic approach. Despite the higher operative costs of robotic rectal resection, overall mean costs were similar in our series.

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Acknowledgments

This study has not been funded in whole or in part by any organisation. This study was performed thanks to the collaboration with the Deloitte Digital España company leaded by Mario de la Peña and Iñaki Moreno.

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Authors and Affiliations

  1. General Surgery Department, Sanchinarro Hospital HM, CEU San Pablo University of Madrid, Madrid, Spain

    Benedetto Ielpo, H. Duran, E. Diaz, I. Fabra, R. Caruso, L. Malavé, V. Ferri, A. Ruiz-Ocaña, E. Jorge, S. Lazzaro, D. Kalivaci, Y. Quijano & E. Vicente

  2. (IVEC) Instituto de Validación de la Eficiencia Clínica, Fundación de Investigación HM Hospitales, Plaza del Conde de valle de Suchil 2, 28015, Madrid, Spain

    J. Nuñez

Authors
  1. Benedetto Ielpo
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  2. H. Duran
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  3. E. Diaz
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  4. I. Fabra
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  5. R. Caruso
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  6. L. Malavé
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  7. V. Ferri
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  8. J. Nuñez
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  9. A. Ruiz-Ocaña
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  10. E. Jorge
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  11. S. Lazzaro
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  12. D. Kalivaci
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  13. Y. Quijano
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  14. E. Vicente
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Corresponding author

Correspondence to Benedetto Ielpo.

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The authors declare that they have no conflict of interest.

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Ielpo, B., Duran, H., Diaz, E. et al. Robotic versus laparoscopic surgery for rectal cancer: a comparative study of clinical outcomes and costs. Int J Colorectal Dis 32, 1423–1429 (2017). https://doi.org/10.1007/s00384-017-2876-7

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  • DOI: https://doi.org/10.1007/s00384-017-2876-7

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