Your browser doesn't support javascript.
loading
Clinical and economic comparative effectiveness of robotic-assisted, video-assisted thoracoscopic, and open lobectomy.
Nguyen, Dao M; Sarkaria, Inderpal S; Song, Chao; Reddy, Rishindra M; Villamizar, Nestor; Herrera, Luis J; Shi, Lu; Liu, Emelline; Rice, David; Oh, Daniel S.
Afiliación
  • Nguyen DM; Thoracic Surgery Section, Department of Surgery, University of Miami, Coral Gables, FL, USA.
  • Sarkaria IS; Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
  • Song C; Health Economics and Outcomes Research, Intuitive Surgical, Sunnyvale, CA, USA.
  • Reddy RM; Department of Surgery, Section of Thoracic Surgery, University of Michigan, Ann Arbor, MI, USA.
  • Villamizar N; Thoracic Surgery Section, Department of Surgery, University of Miami, Coral Gables, FL, USA.
  • Herrera LJ; Thoracic Surgery Section, Orlando Health, University of Florida, Gainesville, FL, USA.
  • Shi L; Department of Public Health Sciences, Clemson University, Clemson, SC, USA.
  • Liu E; Health Economics and Outcomes Research, Intuitive Surgical, Sunnyvale, CA, USA.
  • Rice D; Department of Thoracic and Cardiovascular Surgery, the University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Oh DS; Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Thorac Dis ; 12(3): 296-306, 2020 Mar.
Article en En | MEDLINE | ID: mdl-32274096
BACKGROUND: We sought to evaluate trends and clinical and economic outcomes between robotic-assisted lobectomy (RL), video-assisted thoracoscopic lobectomy (VL), and open pulmonary lobectomy (OL). METHODS: Patients who underwent a lobectomy for malignancy from January 1, 2008, to September 30, 2015, were identified in the Premier Healthcare Database. Propensity score matched (PSM) comparisons were performed between RL versus VL and RL versus OL. Patient characteristics were applied to generate propensity scores. In-hospital and perioperative 30-day outcomes and costs were compared within matched cohorts. RESULTS: From 2008 to 2015, there was a marked decline for OL (71% to 43%, P<0.0001) with a significant increase in RL (1% to 17%, P<0.0001) and VL (28% to 41%, P<0.0001). In the early period (January 2008 to December 2012), total operating room time was longer (P<0.0001) and admission to ICU was more common for RL compared to VL or OL (P<0.0001) although the total length of ICU stay was shorter for RL compared to VL or OL (P<0.0001). In the late period (January 2013 to September 2015), RL was associated with significantly lower rates of complications (P<0.05), conversions, and shorter length of stay than VL and OL. When hospital volume was not considered, costs were higher for RL than VL and OL. In hospitals where >25 lobectomies were performed annually, the total cost of RL was comparable to VL (P=0.09) and OL (P=0.11). CONCLUSIONS: During the study period, the utilization of RL increased substantially and was associated with improved perioperative outcomes compared with VL and OL. When annual hospital volume was >25 cases, these clinical advantages persisted and there was no significant cost difference between RL, VL, or OL. RL is an effective and cost-comparable approach for lobectomy in patients with lung malignancy.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Health_economic_evaluation / Prognostic_studies Idioma: En Revista: J Thorac Dis Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: China

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Health_economic_evaluation / Prognostic_studies Idioma: En Revista: J Thorac Dis Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: China