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


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 14 02 2021
revised: 20 03 2021
accepted: 30 03 2021
pubmed: 16 4 2021
medline: 10 9 2021
entrez: 15 4 2021
Statut: ppublish

Résumé

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). Pubmed, Web of Science and Cochrane Library databases were searched. Studies comparing cost-effectiveness of ODP and MIDP were included. 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. 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.

Sections du résumé

BACKGROUND 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 METHODS
Pubmed, Web of Science and Cochrane Library databases were searched. Studies comparing cost-effectiveness of ODP and MIDP were included.
RESULTS 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 CONCLUSIONS
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.

Identifiants

pubmed: 33853724
pii: S0002-9610(21)00227-0
doi: 10.1016/j.amjsurg.2021.03.066
pii:
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

513-520

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Stefano Partelli (S)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.

Claudio Ricci (C)

Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studorium, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; Division of Pancreatic Surgery, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.

Lorenzo Cinelli (L)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Roberto Maria Montorsi (RM)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Carlo Ingaldi (C)

Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studorium, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; Division of Pancreatic Surgery, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.

Valentina Andreasi (V)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.

Stefano Crippa (S)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.

Laura Alberici (L)

Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studorium, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; Division of Pancreatic Surgery, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.

Riccardo Casadei (R)

Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studorium, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy; Division of Pancreatic Surgery, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy.

Massimo Falconi (M)

Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: falconi.massimo@hsr.it.

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Classifications MeSH