Cost Analysis for Robotic and Open Gastrectomy
Objective:. To determine the magnitude of the perioperative costs associated with robotic gastrectomy (RG). Background:. A robotic surgery platform has a high implementation cost and requires maintenance costs; however, whether the overall cost of RG, including all perioperative costs, is higher tha...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000396 |
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| author | Yuki Hirata, MD, PhD Heather G. Lyu, MD, MBI Ahad M. Azimuddin, MBA Pamela Lu, MD Jeeva Ajith, MBA Jason A. Schmeisser Elizabeth P. Ninan, MBA Kyung Hyun Lee, PhD Brian D. Badgwell, MD, MS Paul Mansfield, MD Naruhiko Ikoma, MD, MS |
| author_facet | Yuki Hirata, MD, PhD Heather G. Lyu, MD, MBI Ahad M. Azimuddin, MBA Pamela Lu, MD Jeeva Ajith, MBA Jason A. Schmeisser Elizabeth P. Ninan, MBA Kyung Hyun Lee, PhD Brian D. Badgwell, MD, MS Paul Mansfield, MD Naruhiko Ikoma, MD, MS |
| author_sort | Yuki Hirata, MD, PhD |
| collection | DOAJ |
| description | Objective:. To determine the magnitude of the perioperative costs associated with robotic gastrectomy (RG).
Background:. A robotic surgery platform has a high implementation cost and requires maintenance costs; however, whether the overall cost of RG, including all perioperative costs, is higher than conventional open gastrectomy (OG) remains unknown.
Methods:. Patients who underwent a major gastrectomy during February 2018 through December 2021 were retrospectively identified. We calculated the perioperative costs of RG and OG and compared them overall as well as in different phases, including intraoperative costs and 30-day postsurgery inpatient and outpatient costs. We investigated factors potentially associated with high cost and estimated the likelihood of RG to reduce overall cost under a Bayesian framework. All cost data were converted to ratios to the average cost of all operations performed at our center in year FY2021.
Results:. We identified 119 patients who underwent gastrectomy. The incidence of postoperative complications (Clavien-Dindo >IIIa; RG, 10% vs OG, 13%) did not significantly differ between approaches. The median length of stay was 3 days shorter for RG versus OG (4 vs 7 days, P < 0.001). Intraoperative cost ratios were significantly higher for RG (RG, 2.6 vs OG, 1.7; P < 0.001). However, postoperative hospitalization cost ratios were significantly lower for RG (RG, 2.8 vs OG, 3.9; P < 0.001). Total perioperative cost ratios were similar between groups (RG, 6.1 vs OG, 6.4; P = 0.534). The multiple Bayesian generalized linear analysis showed RG had 76.5% posterior probability of overall perioperative cost reduction (adjusted risk ratio of 0.95; 95% credible interval, 0.85–1.07).
Conclusions:. Despite increased intraoperative costs, total perioperative costs in the RG group were similar to those in the OG group because of reduced postoperative hospitalization costs. |
| format | Article |
| id | doaj-art-a1a2e30742be4bf89e539d525c261f8e |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-a1a2e30742be4bf89e539d525c261f8e2025-01-24T09:18:25ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-03-0151e39610.1097/AS9.0000000000000396202403000-00031Cost Analysis for Robotic and Open GastrectomyYuki Hirata, MD, PhD0Heather G. Lyu, MD, MBI1Ahad M. Azimuddin, MBA2Pamela Lu, MD3Jeeva Ajith, MBA4Jason A. Schmeisser5Elizabeth P. Ninan, MBA6Kyung Hyun Lee, PhD7Brian D. Badgwell, MD, MS8Paul Mansfield, MD9Naruhiko Ikoma, MD, MS10* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX† Finance, Analytics & Treasury, The University of Texas MD Anderson Cancer Center, Houston, TX† Finance, Analytics & Treasury, The University of Texas MD Anderson Cancer Center, Houston, TX‡ Division of Procedures and Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX§ Center for Clinical Research and Evidence-Based Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX.* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX* From the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TXObjective:. To determine the magnitude of the perioperative costs associated with robotic gastrectomy (RG). Background:. A robotic surgery platform has a high implementation cost and requires maintenance costs; however, whether the overall cost of RG, including all perioperative costs, is higher than conventional open gastrectomy (OG) remains unknown. Methods:. Patients who underwent a major gastrectomy during February 2018 through December 2021 were retrospectively identified. We calculated the perioperative costs of RG and OG and compared them overall as well as in different phases, including intraoperative costs and 30-day postsurgery inpatient and outpatient costs. We investigated factors potentially associated with high cost and estimated the likelihood of RG to reduce overall cost under a Bayesian framework. All cost data were converted to ratios to the average cost of all operations performed at our center in year FY2021. Results:. We identified 119 patients who underwent gastrectomy. The incidence of postoperative complications (Clavien-Dindo >IIIa; RG, 10% vs OG, 13%) did not significantly differ between approaches. The median length of stay was 3 days shorter for RG versus OG (4 vs 7 days, P < 0.001). Intraoperative cost ratios were significantly higher for RG (RG, 2.6 vs OG, 1.7; P < 0.001). However, postoperative hospitalization cost ratios were significantly lower for RG (RG, 2.8 vs OG, 3.9; P < 0.001). Total perioperative cost ratios were similar between groups (RG, 6.1 vs OG, 6.4; P = 0.534). The multiple Bayesian generalized linear analysis showed RG had 76.5% posterior probability of overall perioperative cost reduction (adjusted risk ratio of 0.95; 95% credible interval, 0.85–1.07). Conclusions:. Despite increased intraoperative costs, total perioperative costs in the RG group were similar to those in the OG group because of reduced postoperative hospitalization costs.http://journals.lww.com/10.1097/AS9.0000000000000396 |
| spellingShingle | Yuki Hirata, MD, PhD Heather G. Lyu, MD, MBI Ahad M. Azimuddin, MBA Pamela Lu, MD Jeeva Ajith, MBA Jason A. Schmeisser Elizabeth P. Ninan, MBA Kyung Hyun Lee, PhD Brian D. Badgwell, MD, MS Paul Mansfield, MD Naruhiko Ikoma, MD, MS Cost Analysis for Robotic and Open Gastrectomy Annals of Surgery Open |
| title | Cost Analysis for Robotic and Open Gastrectomy |
| title_full | Cost Analysis for Robotic and Open Gastrectomy |
| title_fullStr | Cost Analysis for Robotic and Open Gastrectomy |
| title_full_unstemmed | Cost Analysis for Robotic and Open Gastrectomy |
| title_short | Cost Analysis for Robotic and Open Gastrectomy |
| title_sort | cost analysis for robotic and open gastrectomy |
| url | http://journals.lww.com/10.1097/AS9.0000000000000396 |
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