Cost-analysis comparison of robot-assisted laparoscopic radical cystectomy (RC) vs open RC.

Abstract:

OBJECTIVE:• To systematically review and compare the economic burden of open radical cystectomy (ORC) vs robot-assisted laparoscopic radical cystectomy (RALRC) with pelvic lymph node dissection and urinary diversion. PATIENTS AND METHODS:• A Medline search was conducted to identify English language articles regarding RC with urinary diversion. The resulting articles were then further restricted by the terms 'laparoscopic', 'robotic', or 'robotic-assisted'.In all, three articles were identified. • Data from each of these articles were then collected on cost performance in addition to relevant clinical variables, such as length of stay (LOS), operative duration, and complication rates. • When possible, data were subdivided by ileal conduit (IC), continent cutaneous diversion (CCD), and orthotopic neobladder (ON) subgroups. • Direct costs resulting from ORC or RALRC with accompanying hospitalization were identified. The indirect costs of complications were considered. RESULTS:• Despite an increased materials cost, RALRC was less expensive than ORC when the cost of complications was considered. • RALRC was less expensive than ORC for IC and CCD, but the cost advantage deteriorated for ON. • The largest cost drivers cited in the published data were LOS, operative durations, and daily hospitalizations costs. • RALRC demonstrated shorter LOS compared with ORC, although this effect was insufficient to offset the increased cost of robotic surgery. • Complications materially affected cost performance. CONCLUSIONS:• Despite an increased materials cost, RALRC can be more cost efficient than ORC as a treatment for bladder cancer when the impact of complications are considered. • This effect is most pronounced for patients undergoing IC.

journal_name

BJU Int

journal_title

BJU international

authors

Lee R,Chughtai B,Herman M,Shariat SF,Scherr DS

doi

10.1111/j.1464-410X.2011.10468.x

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

976-83

issue

6 Pt 2

eissn

1464-4096

issn

1464-410X

journal_volume

108

pub_type

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