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
Abstract 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...
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doaj-8d2ec6f665db48258716a153398505f32020-11-25T04:08:37ZengBMCBMC Urology1471-24902019-11-0119111110.1186/s12894-019-0533-xCost comparison between open radical cystectomy, laparoscopic radical cystectomy, and robot-assisted radical cystectomy for patients with bladder cancer: a systematic review of segmental costsYasuhiro Morii0Takahiro Osawa1Teppei Suzuki2Nobuo Shinohara3Toru Harabayashi4Tomoki Ishikawa5Takumi Tanikawa6Hiroko Yamashina7Katsuhiko Ogasawara8Graduate school of Health Sciences, Hokkaido UniversityDepartment of Renal and Genitourinary Surgery Graduate School of Medicine, Hokkaido UniversityHokkaido University of Education, Art, and Sports BusinessDepartment of Renal and Genitourinary Surgery Graduate School of Medicine, Hokkaido UniversityDepartment of Urology, Hokkaido Cancer CenterFaculty of Health Sciences, Hokkaido UniversityFaculty of Health Sciences, Hokkaido University of ScienceFaculty of Health Sciences, Hokkaido UniversityFaculty of Health Sciences, Hokkaido UniversityAbstract 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.http://link.springer.com/article/10.1186/s12894-019-0533-x |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yasuhiro Morii Takahiro Osawa Teppei Suzuki Nobuo Shinohara Toru Harabayashi Tomoki Ishikawa Takumi Tanikawa Hiroko Yamashina Katsuhiko Ogasawara |
spellingShingle |
Yasuhiro Morii Takahiro Osawa Teppei Suzuki Nobuo Shinohara Toru Harabayashi Tomoki Ishikawa Takumi Tanikawa Hiroko Yamashina Katsuhiko Ogasawara 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 |
author_facet |
Yasuhiro Morii Takahiro Osawa Teppei Suzuki Nobuo Shinohara Toru Harabayashi Tomoki Ishikawa Takumi Tanikawa Hiroko Yamashina Katsuhiko Ogasawara |
author_sort |
Yasuhiro Morii |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publisher |
BMC |
series |
BMC Urology |
issn |
1471-2490 |
publishDate |
2019-11-01 |
description |
Abstract 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. |
url |
http://link.springer.com/article/10.1186/s12894-019-0533-x |
work_keys_str_mv |
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