Detailed Abstract
[Poster Presentation 5 - Liver (Liver Disease/Surgery)]
[LV PP 5-S3] Cost Analysis of Robotic And Laparoscopic Liver Resections: a Propensity Score Matched Study Based on Real-world Data
Mariano Cesare GIGLIO 1, Gianluca CASSESE 1, Silvia CAMPANILE 1, Gianluca ROMPIANESI 1, Fabiana RUBBA 1, Roberto MONTALTI 1, Roberto TROISI 1
1 Division of Hepatobiliary And Pancreatic Surgery And Transplantation, Federico II University Hospital, Naples, Italy, ITALY
Background : The robotic approach is increasingly used to perform liver resections, however its economic sustainability remains an open question. This study aimed to perform an economic analysis of the costs of laparoscopic and robotic liver resections, from the perspective of Italian NHS.
Methods : Patients undergoing laparoscopic or robotic liver resection at a single University Hospital were identified from a prospective database. Data on patients' characteristics, operations performed, instruments used, and clinical course were collected. Patients were matched for age, gender, BMI, ASA, liver resection, and liver disease using propensity scores. An economic comparative analysis including all variable costs was performed.
Results : After matching, 52 patients per group were included. There were no differences between the robotic and laparoscopic groups in the length of stay (7 vs 5 days, p=0.085), transfusion rates (17.6% vs 20.6%, p=1.00), and postoperative complications (20.6% vs 23.5%, p=1.00). Hospital stay costs were 4.985€ and 3.785€ for the robotic and laparoscopic group (p=0.085). Robotic hepatectomies required more time (400 vs 307 min, p=0.022), with higher operating room (4.400€ vs 3.382€, p=0.022) and surgical instruments (4.052€ vs. 1.950€, p<0.001) costs. The final median costs were 13.623€ and 9.285€ for robotic and laparoscopic hepatectomies, respectively (p<0.001).
Conclusions : Robotic liver resections have significantly higher costs (+4338€, median) than laparoscopic ones. This is mainly due to surgical instruments costs, which are not offset by other costs.
Methods : Patients undergoing laparoscopic or robotic liver resection at a single University Hospital were identified from a prospective database. Data on patients' characteristics, operations performed, instruments used, and clinical course were collected. Patients were matched for age, gender, BMI, ASA, liver resection, and liver disease using propensity scores. An economic comparative analysis including all variable costs was performed.
Results : After matching, 52 patients per group were included. There were no differences between the robotic and laparoscopic groups in the length of stay (7 vs 5 days, p=0.085), transfusion rates (17.6% vs 20.6%, p=1.00), and postoperative complications (20.6% vs 23.5%, p=1.00). Hospital stay costs were 4.985€ and 3.785€ for the robotic and laparoscopic group (p=0.085). Robotic hepatectomies required more time (400 vs 307 min, p=0.022), with higher operating room (4.400€ vs 3.382€, p=0.022) and surgical instruments (4.052€ vs. 1.950€, p<0.001) costs. The final median costs were 13.623€ and 9.285€ for robotic and laparoscopic hepatectomies, respectively (p<0.001).
Conclusions : Robotic liver resections have significantly higher costs (+4338€, median) than laparoscopic ones. This is mainly due to surgical instruments costs, which are not offset by other costs.
SESSION
Poster Presentation 5
Zone F 3/21/2024 2:50 PM - 3:30 PM