Aziz Hassan, Hanna Kamil, Lashkari Nassim, Ahmad Noor-Us-Sabah, Genyk Yuri, Sheikh Mohd Raashid
Department of Surgery, Keck School of Medicine, 5116University of Southern California, Los Angeles, CA, United States.
Department of Surgery, 8138Westchester Medical Center, Valhalla, NY, United States.
Am Surg. 2022 Sep;88(9):2331-2337. doi: 10.1177/00031348211011063. Epub 2021 Apr 16.
Most liver resections performed in the United States are open. With the ever-increasing role of robotic surgery, our study's role is to assess national outcomes based on the surgical approach.
We performed a retrospective analysis of the 2015 National Readmission Database (NRD). We selected patients undergoing open, laparoscopic, and robotic hepatectomy. Propensity score matching was performed to match the three groups in terms of demographics, hospital characteristics, and resection type. Our primary outcome was 6-month readmission rates and associated costs.
3,872 patients were included in the analysis (open = 3,420, laparoscopic = 343, and robotic = 109). Robotic liver resection has lower 6-month readmission rates (18.3%) than the laparoscopic (26.7%) and open (30%) counterparts. The robotic approach was more cost-effective ($127,716.56 ± 12,567.31) than the open ($157,880.82 ± 18,560.2) and laparoscopic approach ($152,060.78 ± 8,890.13) in terms of the total cost which includes cost per readmission.
There is a financial benefit of using robotics in terms of cost, hospital length of stay, and readmission rates in patients undergoing liver resection, cost.
在美国，大多数肝脏切除术采用开放手术方式。随着机器人手术的作用日益增强，我们研究的目的是根据手术方式评估全国范围内的手术结果。
我们对2015年国家再入院数据库（NRD）进行了回顾性分析。我们选择了接受开放、腹腔镜和机器人肝切除术的患者。进行倾向评分匹配以在人口统计学、医院特征和切除类型方面对三组进行匹配。我们的主要结局是6个月再入院率及相关费用。
3872例患者纳入分析（开放手术组=3420例，腹腔镜手术组=343例，机器人手术组=109例）。机器人肝切除术的6个月再入院率（18.3%）低于腹腔镜手术组（26.7%）和开放手术组（30%）。就包括每次再入院费用在内的总成本而言，机器人手术方式比开放手术（157880.82美元±18560.2美元）和腹腔镜手术方式（152060.78美元±8890.13美元）更具成本效益（127716.56美元±12567.31美元）。
在接受肝脏切除术的患者中，就成本、住院时间和再入院率而言，使用机器人手术具有经济优势。
