ABSTRACT
PURPOSE: The objective of this study is to compare the operative time, intraoperative complications, length of stay, readmission rates, overall complications, mortality, and cost associated with Robotic Surgery (RS) and Laparascopic Surgery (LS) in anti-reflux and hiatal hernia surgery. METHODS: A comprehensive literature search was conducted using MEDLINE (via PubMed), Web of Science and Scopus databases. Studies comparing short-term outcomes and cost between RS and LS in patients with anti-reflux and hiatal hernia were included. Data on operative time, complications, length of stay, readmission rates, overall complications, mortality, and cost were extracted. Quality assessment of the included studies was performed using the MINORS scale. RESULTS: Fourteen retrospective observational studies involving a total of 555,368 participants were included in the meta-analysis. The results showed no statistically significant difference in operative time, intraoperative complications, length of stay, readmission rates, overall complications, and mortality between RS and LS. However, LS was associated with lower costs compared to RS. CONCLUSION: This systematic review and meta-analysis demonstrates that RS has non-inferior short-term outcomes in anti-reflux and hiatal hernia surgery, compared to LS. LS is more cost-effective, but RS offers potential benefits such as improved visualization and enhanced surgical techniques. Further research, including randomized controlled trials and long-term outcome studies, is needed to validate and refine these findings.
Subject(s)
Gastroesophageal Reflux , Hernia, Hiatal , Laparoscopy , Robotic Surgical Procedures , Humans , Hernia, Hiatal/surgery , Hernia, Hiatal/economics , Robotic Surgical Procedures/economics , Robotic Surgical Procedures/adverse effects , Laparoscopy/economics , Laparoscopy/adverse effects , Gastroesophageal Reflux/surgery , Gastroesophageal Reflux/economics , Operative Time , Herniorrhaphy/economics , Herniorrhaphy/methods , Herniorrhaphy/adverse effects , Treatment Outcome , Length of Stay/economics , Fundoplication/economics , Fundoplication/methods , Patient Readmission/economics , Patient Readmission/statistics & numerical data , Postoperative Complications/economicsABSTRACT
No abstract available.
Subject(s)
Humans , Gastroesophageal Reflux/economics , Histamine Antagonists/therapeutic use , Practice Guidelines as Topic , Proton Pump Inhibitors/therapeutic useABSTRACT
Objetivos: estimar el impacto de los síntomas de reflujo gastroesofágico(SRGE) sobre el uso de servicios sanitarios y el absentismolaboral en España.Métodos: estudio transversal sobre 2.500 personas representativasde la población española de 40 a 79 años. La informaciónse recogió mediante entrevista telefónica en enero de 2002 usandoel cuestionario de Locke, después de su adaptación transculturaly validación para uso telefónico en España.Resultados: los SRGE son responsables de 296,8 (IC95%:245,3-348,7) visitas al médico por 1.000 habitantes/año, de larealización de 24 (IC95%: 18-30) estudios radiológicos esófagogastroduodenalespor 1.000 habitantes-año, 32,4 (IC95%: 25,5-39,3) endoscopias digestivas altas por 1.000 habitantes/año, y dela pérdida de 201 (IC95%: 0-411,1) días laborables por 1.000habitantes empleados con SRGE y año. Respecto al consumo defármacos, los SRGE generaron 4.092 (IC95%: 3.300-5.133) díasde tratamiento con antagonistas H2 por 1.000 habitantes-año,9.030 (IC95%: 7.846-10.332) días de tratamiento con inhibidoresde la bomba de protones por cada 1.000 habitantes/año, y1.082 (IC95%: 519-1549) días de tratamiento con procinéticospor 1.000 habitantes/año.Conclusiones: los SRGE tienen un gran impacto sobre la utilizaciónde recursos sanitarios y el absentismo laboral en España.Ello contrasta con la extendida opinión de que se trata de un trastornode escasa importancia
Objectives: to estimate the impact of gastroesophageal reflux(GER) symptoms on the utilization of healthcare services and workabsenteeism in Spain.Methods: a cross-sectional study on 2,500 subjects representativeof the Spanish population from 40 to 79 years of age. Datawere collected via a telephone interview in January 2002 usingLockes questionnaire after its cross-cultural adaptation and validationfor telephone use in Spain.Results: GER is responsible for 296.8 doctor consultations(95% CI: 245.3-348.7) per 1,000 inhabitants per year, for 24esophagogastrointestinal radiographic studies per 1,000 inhabitantsper year (95% CI: 18-30), for 32.4 (95% CI: 25.5-39.3)high digestive endoscopies per 1,000 inhabitants per year, andfor the loss of 201 (95% CI: 0-411.1) working days per 1,000employed inhabitants with GER per year. In relation to medicationintake, GER resulted in 4,092 (95% CI: 3,300-5,133) treatmentdays with H2 antagonists per 1,000 inhabitants per year,9,030 (95% CI: 7,846-10,332) treatment days with proton pumpinhibitors per 1,000 inhabitants per year, and 1,082 (95% CI:519-1,549) treatment days with prokinetics per 1,000 inhabitantsper year.Conclusions: GER has a large impact on the utilization ofhealthcare resources and work absenteeism in Spain, in contrastto the widespread belief that it is an illness of little importance