Kosa Sarah D, Ferguson Sarah E, Panzarella Tony, Lau Susie, Abitbol Jeremie, Samouëlian Vanessa, Giede Christopher, Steed Helen, Renkosinski Benjamin, Gien Lilian T, Bernardini Marcus Q
Division of Gynecologic Oncology, Princess Margaret Cancer Centre/University Health Network/Sinai Health Systems, Toronto, Ontario, Canada.
Department of Health Research Methods, Evidence, and Impacts, McMaster University, Hamilton, Ontario, Canada.
J Surg Oncol. 2022 Mar;125(4):747-753. doi: 10.1002/jso.26769. Epub 2021 Dec 14.
To compare the immediate operating room (OR), inpatient, and overall costs between three surgical modalities among women with endometrial cancer (EC) and Class III obesity or higher.
A multicentre prospective observational study examined outcomes of women, with early stage EC, treated surgically. Resource use was collected for OR costs including OR time, equipment, and inpatient costs. Median OR, inpatient, and overall costs across surgical modalities were analyzed using an Independent-Samples Kruskal-Wallis Test among patients with BMI ≥ 40.
Out of 520 women, 103 had a BMI ≥ 40. Among women with BMI ≥ 40: median OR costs were $4197.02 for laparotomy, $5524.63 for non-robotic assisted laparoscopy, and $7225.16 for robotic-assisted laparoscopy (p < 0.001) and median inpatient costs were $5584.28 for laparotomy, $3042.07 for non-robotic assisted laparoscopy, and $1794.51 for robotic-assisted laparoscopy (p < 0.001). There were no statistically significant differences in the median overall costs: $10 291.50 for laparotomy, $8412.63 for non-robotic assisted laparoscopy, and $9002.48 for robotic-assisted laparoscopy (p = 0.185).
There was no difference in overall costs between the three surgical modalities in patient with BMI ≥ 40. Given the similar costs, any form of minimally invasive surgery should be promoted in this population.
比较子宫内膜癌（EC）且肥胖程度为III级及以上的女性患者接受三种手术方式后的手术室即时费用、住院费用及总费用。
一项多中心前瞻性观察性研究对早期EC女性患者的手术治疗结果进行了考察。收集了包括手术室时间、设备在内的手术室费用及住院费用等资源使用情况。对体重指数（BMI）≥40的患者，采用独立样本克鲁斯卡尔-沃利斯检验分析了各手术方式的手术室费用中位数、住院费用中位数及总费用中位数。
在520名女性患者中，103人体重指数≥40。在BMI≥40的女性患者中：开腹手术的手术室费用中位数为4197.02美元，非机器人辅助腹腔镜手术为5524.63美元，机器人辅助腹腔镜手术为7225.16美元（p<0.001）；开腹手术的住院费用中位数为5584.28美元，非机器人辅助腹腔镜手术为3042.07美元，机器人辅助腹腔镜手术为1794.51美元（p<0.001）。总费用中位数无统计学显著差异：开腹手术为10291.50美元，非机器人辅助腹腔镜手术为8412.63美元，机器人辅助腹腔镜手术为9002.48美元（p=0.185）。
BMI≥40的患者接受三种手术方式后的总费用无差异。鉴于费用相似，应在该人群中推广任何形式的微创手术。
