論文

国際誌
2019年11月8日

Cost comparison between open radical cystectomy, laparoscopic radical cystectomy, and robot-assisted radical cystectomy for patients with bladder cancer: a systematic review of segmental costs.

BMC urology
  • Yasuhiro Morii
  • ,
  • Takahiro Osawa
  • ,
  • Teppei Suzuki
  • ,
  • Nobuo Shinohara
  • ,
  • Toru Harabayashi
  • ,
  • Tomoki Ishikawa
  • ,
  • Takumi Tanikawa
  • ,
  • Hiroko Yamashina
  • ,
  • Katsuhiko Ogasawara

19
1
開始ページ
110
終了ページ
110
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12894-019-0533-x

BACKGROUND: Robot-assisted radical cystectomy is becoming a common treatment for bladder carcinoma. However, in comparison with open radical cystectomy, its cost-effectiveness has not been confirmed. Although few published reviews have compared total costs between the two surgical procedures, no study has compared segmental costs and explained their impact on total costs. METHODS: A systematic review was conducted based on studies on the segmental costs of open, laparoscopic, and robot-assisted radical cystectomy using PubMed, Web of Science, and Cochrane Library databases to provide insight into cost-effective management methods for radical cystectomy. The segmental costs included operating, robot-related, complication, and length of stay costs. A sensitivity analysis was conducted to determine the impact of the annual number of cases on the per-case robot-related costs. RESULTS: We identified two studies that compared open and laparoscopic surgeries and nine that compared open and robotic surgeries. Open radical cystectomy costs were higher than those of robotic surgeries in two retrospective single-institution studies, while robot-assisted radical cystectomy costs were higher in 1 retrospective single-institution study, 1 randomized controlled trial, and 4 large database studies. Operating costs were higher for robotic surgery, and accounted for 63.1-70.5% of the total robotic surgery cost. Sensitivity analysis revealed that robot-related costs were not a large proportion of total surgery costs in institutions with a large number of cases but accounted for a large proportion of total costs in centers with a small number of cases. CONCLUSIONS: The results show that robot-assisted radical cystectomy is more expensive than open radical cystectomy. The most effective methods to decrease costs associated with robotic surgery include a decrease in operating time and an increase in the number of cases. Further research is required on the cost-effectiveness of surgeries, including quality measures such as quality of life and quality-adjusted life years.

リンク情報
DOI
https://doi.org/10.1186/s12894-019-0533-x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31703573
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842244

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