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

Overview

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.

publication date

  • September 1, 2011

Research

keywords

  • Cystectomy
  • Laparoscopy
  • Lymph Node Excision
  • Robotics
  • Urinary Bladder Neoplasms
  • Urinary Diversion

Identity

Scopus Document Identifier

  • 80052842566

Digital Object Identifier (DOI)

  • 10.1111/j.1464-410X.2011.10468.x

PubMed ID

  • 21917100

Additional Document Info

volume

  • 108

issue

  • 6 Pt 2