Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
J Gastrointest Surg. 2012 Dec;16(12):2233-8. doi: 10.1007/s11605-012-2040-1. Epub 2012 Oct 5.
The purpose of this study was to compare the clinical and economic outcomes of robotic versus laparoscopic left lateral sectionectomy (LLS).
A retrospective analysis was made comparing robotic (n = 11) and laparoscopic (n = 18) LLS performed at the University of Pittsburgh Medical Center between January 2009 and July 2011. Demographic data, operative, and postoperative outcomes were collected.
Demographic and tumor characteristics of robotic and laparoscopic LLS were similar. There were also no significant differences in operative outcomes including estimated blood loss and operating room time. Patients undergoing robotic LLS had more admissions to the ICU (46 versus 6 %), increased rate of minor complications (27 versus 0 %), and longer lengths of stay (4 versus 3 days). There were no significant differences in major complication rates or 90-day mortality. The cost of robotic and laparoscopic LLS was not significantly different when only considering direct costs ($5,130 versus $4,408, p = 0.401). However, robotic LLS costs were significantly greater when including indirect costs, which were estimated to be $1,423 per robotic case ($6,553 versus $4,408, p = 0.021).
Robotic LLS yields slightly inferior clinical outcomes and increased cost compared to the laparoscopic approach.
本研究旨在比较机器人辅助与腹腔镜左外叶切除术（LLS）的临床和经济结局。
回顾性分析了 2009 年 1 月至 2011 年 7 月在匹兹堡大学医学中心进行的机器人（n=11）和腹腔镜（n=18）LLS。收集了人口统计学数据、手术和术后结果。
机器人和腹腔镜 LLS 的人口统计学和肿瘤特征相似。手术结果，包括估计出血量和手术室时间，也无显著差异。行机器人 LLS 的患者 ICU 入院率更高（46%对 6%）、轻微并发症发生率更高（27%对 0%）、住院时间更长（4 天对 3 天）。主要并发症发生率或 90 天死亡率无显著差异。仅考虑直接成本时，机器人和腹腔镜 LLS 的成本无显著差异（5130 美元对 4408 美元，p=0.401）。然而，当包括间接成本时，机器人 LLS 的成本显著更高，估计每例机器人手术为 1423 美元（6553 美元对 4408 美元，p=0.021）。
与腹腔镜方法相比，机器人 LLS 的临床结局略差，且成本增加。
