Evaluation of cost-effectiveness among open, laparoscopic and robotic distal pancreatectomy: A systematic review and meta-analysis.

Published on Apr 7, 2021in American Journal of Surgery2.125
· DOI :10.1016/J.AMJSURG.2021.03.066
Stefano Partelli43
Estimated H-index: 43
Claudio Ricci28
Estimated H-index: 28
+ 7 AuthorsMassimo Falconi105
Estimated H-index: 105
Abstract Background The cost-effectiveness of minimally invasive distal pancreatectomy (MIDP) is still a matter of debate. This study compares the cost-effectiveness of open (ODP), laparoscopic (LDP) and robotic distal pancreatectomy (RDP). Methods Pubmed, Web of Science and Cochrane Library databases were searched. Studies comparing cost-effectiveness of ODP and MIDP were included. Results A total of 1052 titles were screened and 16 articles were included in the study, 2431 patients in total. LDP resulted the most cost-efficient procedure, with a mean total cost of 14,682 ± 5665 € and the lowest readmission rates. ODP had lower surgical procedure costs, 3867 ± 768 €. RDP was the safest approach regarding hospital stay costs (5239 ± 1741 €), length of hospital stay, morbidity, clinically relevant pancreatic fistula and reoperations. Conclusion In this meta-analysis MIDP resulted as the most cost-effective approach. LDP seems to be protective against high costs, but RDP seems to be safer.
BACKGROUND: This study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP). METHOD: All patients who underwent LDP or RDP from 2011 to 2017 and with a minimum postoperative follow-up of 12 months were included in the study. To minimize bias, a propensity score-matched analysis (1:2) was performed. Two different questionnaires (EORTC QLQ-C30 and EQ-5D) were completed by the patients. The mean differential cost and mean differe...
13 CitationsSource
AIM: There is no study in the literature that evaluates the cost-effectiveness of robotic distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP). We performed a comparative study of RDP and LDP with the aim of evaluating clinical and cost-effective outcomes. MATERIAL AND METHODS: This is an observational, comparative prospective nonrandomized study. The primary end point was to compare the cost-effectiveness differences between both groups. A willingness to pay of euro20 000 a...
4 CitationsSource
#1Miranda Cumpston (University of Newcastle)H-Index: 7
#2Tianjing Li (Johns Hopkins University)H-Index: 33
Last. James Thomas (UCL: University College London)H-Index: 43
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695 CitationsSource
#1J. van Hilst (VU: VU University Amsterdam)H-Index: 4
#2E. A. Strating (VU: VU University Amsterdam)H-Index: 1
Last. M. Abu Hilal (University of Southampton)H-Index: 17
view all 27 authors...
Background: Minimally invasive distal pancreatectomy decreases time to functional recovery compared with open distal pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established. Methods: The LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open distal pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quali...
24 CitationsSource
#1Sergio Alfieri (UCSC: Catholic University of the Sacred Heart)H-Index: 23
#2Giovanni ButturiniH-Index: 51
Last. Giuseppe Quero (UCSC: Catholic University of the Sacred Heart)H-Index: 13
view all 19 authors...
Purpose Minimally invasive surgery has increasingly gained popularity as a treatment of choice for pancreatectomy with encouraging initial results in robotic distal pancreatectomy (RDP). However, few data are available on the comparison between RDP and laparoscopic distal pancreatectomy (LDP) for pancreatic neuroendocrine tumors (pNETs). Our aim, thus, is to compare perioperative and long-term outcomes as well as total costs of RDP and LDP for pNETs.
20 CitationsSource
#1Jony van Hilst (UvA: University of Amsterdam)H-Index: 17
#2Maarten Korrel (UvA: University of Amsterdam)H-Index: 4
Last. Marc G. Besselink (UvA: University of Amsterdam)H-Index: 84
view all 10 authors...
Abstract In the absence of randomized trials, uncertainty regarding the oncologic efficacy of minimally invasive distal pancreatectomy (MIDP) remains. This systematic review aimed to compare oncologic outcomes after MIDP (laparoscopic or robot-assisted) and open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC). Matched and non-matched studies were included. Pooled analyses were performed for pathology (e.g., microscopically radical (R0) resection and lymph nod...
35 CitationsSource
#1Alexander V. Fisher (UW: University of Wisconsin-Madison)H-Index: 10
#2Sara Fernandes-Taylor (UW: University of Wisconsin-Madison)H-Index: 16
Last. Daniel E. Abbott (UW: University of Wisconsin-Madison)H-Index: 12
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Abstract Background Minimally invasive distal pancreatectomy (MIDP) is associated with improved peri-operative outcomes compared to the open approach, though cost-effectiveness of MIDP remains unclear. Methods Patients with pancreatic tumors undergoing open (ODP), robotic (RDP), or laparoscopic distal pancreatectomy (LDP) between 2012-2014 were identified through the Truven Health MarketScan® Database. Median costs (payments) for the index operation and 90-day readmissions were calculated. Multi...
18 CitationsSource
#1Jony van HilstH-Index: 17
#2Thijs de RooijH-Index: 18
Last. Marc G. BesselinkH-Index: 84
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Abstract Background The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow. The worldwide utilization of MIPR and attitude towards future perspectives of MIPR remains unknown. Methods An anonymous survey on MIPR was sent to the members of six international associations of Hepato-Pancreato-Biliary (HPB) surgery. Results The survey was completed by 435 surgeons from 50 countries, with each surgeon performing a median of 22 (IQR 12–40) pancreatic res...
60 CitationsSource
#1Thijs de Rooij (UvA: University of Amsterdam)H-Index: 5
#1Thijs de Rooij (UvA: University of Amsterdam)H-Index: 18
Last. Marc G. Besselink (UvA: University of Amsterdam)H-Index: 84
view all 26 authors...
Objective:This trial followed a structured nationwide training program in minimally invasive distal pancreatectomy (MIDP), according to the IDEAL framework for surgical innovation, and aimed to compare time to functional recovery after minimally invasive and open distal pancreatectomy (ODP).Backgrou
154 CitationsSource
#1Maylis RodriguezH-Index: 2
#2R. Memeo (European Institute)H-Index: 4
Last. Patrick Pessaux (UDS: University of Strasbourg)H-Index: 62
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Background: The aim of this study was to analyze the clinical and economic impact of robotic distal pancreatectomy, laparoscopic distal pancreatectomy, and open distal pancreatectomy. Methods: All consecutive patients who underwent distal pancreatic resection for benign and malignant diseases between January 2012 and December 2015 were prospectively included. Cost analysis was performed; all charges from patient admission to discharge were considered. Results: There were 21 robotic (RDP), 25 lap...
20 CitationsSource
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