Department of Health Economic and Outcomes Research, Medtronic ULC, 99 Hereford St., Brampton, ON, L6Y 0R3, Canada.
Champlain Regional Cancer Program Depts OB/GYN, Surgery, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
J Robot Surg. 2023 Dec;17(6):2671-2685. doi: 10.1007/s11701-023-01731-7. Epub 2023 Oct 16.
This study aims to conduct a systematic review of full economic analyses of robotic-assisted surgery (RAS) in adults' thoracic and abdominopelvic indications. Authors used Medline, EMBASE, and PubMed to conduct a systematic review following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. Fully published economic articles in English were included. Methodology and reporting quality were assessed using standardized tools. Majority of studies (28/33) were on oncology procedures. Radical prostatectomy was the most reported procedure (16/33). Twenty-eight studies used quality-adjusted life years, and five used complication rates as outcomes. Nine used primary and 24 studies used secondary data. All studies used modeling. In 81% of studies (27/33), RAS was cost-effective or potentially cost-effective compared to comparator procedures, including radical prostatectomy, nephrectomy, and cystectomy. Societal perspective, longer-term time-horizon, and larger volumes favored RAS. Cost-drivers were length of stay and equipment cost. From societal and payer perspectives, robotic-assisted surgery is a cost-effective strategy for thoracic and abdominopelvic procedures.Clinical trial registration This study is a systematic review with no intervention, not a clinical trial.
本研究旨在对成人胸腹部适应证的机器人辅助手术（RAS）的全经济分析进行系统评价。作者使用 Medline、EMBASE 和 PubMed 按照系统评价和荟萃分析的首选报告项目（PRISMA）2020 指南进行了系统评价。纳入了全英文发表的经济文章。使用标准化工具评估方法学和报告质量。大多数研究（33 项中的 28 项）为肿瘤学手术。根治性前列腺切除术是报告最多的手术（33 项中的 16 项）。28 项研究使用了质量调整生命年，5 项研究使用了并发症发生率作为结果。9 项研究使用了初级数据，24 项研究使用了次级数据。所有研究均使用建模。在 81%的研究（33 项中的 27 项）中，与比较手术（包括根治性前列腺切除术、肾切除术和膀胱切除术）相比，RAS 具有成本效益或潜在成本效益。从社会角度看，更长的时间范围和更大的手术量有利于 RAS。成本驱动因素是住院时间和设备成本。从社会和支付者的角度来看，机器人辅助手术是胸腹部手术的一种具有成本效益的策略。临床试验注册 本研究是一项系统评价，没有干预措施，不属于临床试验。
