Author/Authors :
rodriguez, maylis nouvel hôpital civil, Strasbourg, France , memeo, riccardo research institute against digestive cancer - institut de recherche contre les cancers de l’appareil digestif (ircad), Strasbourg, France , memeo, riccardo nouvel hôpital civil, Strasbourg, France , memeo, riccardo université de strasbourg - institut hospitalo-universitaire (ihu), institute for minimally invasive hybrid image-guided surgery, Strasbourg, France , leon, piera hôpital saint-eloi - department of digestive surgery, Montpellier, France , panaro, fabrizio hôpital saint-eloi - department of digestive surgery, Montpellier, France , tzedakis, stylianos nouvel hôpital civil, Strasbourg, France , perotto, ornella nouvel hôpital civil, Strasbourg, France , varatharajah, sharmini nouvel hôpital civil, Strasbourg, France , de angelis, nicola nouvel hôpital civil, Strasbourg, France , riva, pietro nouvel hôpital civil, Strasbourg, France , mutter, didier université de strasbourg - institut hospitalo-universitaire (ihu), institute for minimally invasive hybrid image-guided surgery, Strasbourg, France , mutter, didier research institute against digestive cancer - institut de recherche contre les cancers de l’appareil digestif (ircad), Strasbourg, France , mutter, didier nouvel hôpital civil, Strasbourg, France , navarro, francis hôpital saint-eloi - department of digestive surgery, Montpellier, France , marescaux, jacques research institute against digestive cancer - institut de recherche contre les cancers de l appareil digestif (ircad), strasbourg, france , marescaux, jacques université de strasbourg - institut hospitalo-universitaire (ihu), institute for minimally invasive hybrid image-guided surgery, Strasbourg, France , pessaux, patrick research institute against digestive cancer - institut de recherche contre les cancers de l’appareil digestif (ircad), Strasbourg, France , pessaux, patrick nouvel hôpital civil, Strasbourg, France , pessaux, patrick université de strasbourg - institut hospitalo-universitaire (ihu), institute for minimally invasive hybrid image-guided surgery, Strasbourg, France
Abstract :
Background: The aim of this study was to analyze the clinical and economic impact of robotic distalpancreatectomy, laparoscopic distal pancreatectomy, and open distal pancreatectomy. Methods: All consecutive patients who underwent distal pancreatic resection for benign and malignant diseases between January 2012 and December 2015 were prospectively included. Cost analysis was performed; all charges from patient admission to discharge were considered. Results: There were 21 robotic (RDP), 25 laparoscopic (LDP), and 43 open (ODP) procedures. Operative time was longer in the RDP group (RDP =345 minutes, LDP =306 min, ODP =251 min, P=0.01). Blood loss was higher in the ODP group (RDP =192 mL, LDP =356 mL, ODP =573 mL, P=0.0002). Spleen preservation was more frequent in the RDP group (RDP =66.6%, LDP =61.9%, ODP =9.3%, P=0.001). The rate of patients with Clavien-Dindo grade III was higher in the ODP group (RDP =0%, LDP =12%, ODP =23%, P=0.01), especially for non-surgical complications, which were more frequent in the ODP group (RDP =9.5%, LDP =24%, ODP =41.8%, P=0.02). Length of hospital stay was increased in the ODP group (ODP =19 days, LDP =13 days, RDP =11 days, P=0.007). The total cost of the procedure, including the surgical procedure and postoperative course was higher in the ODP group (ODP =30,929 Euros, LDP =22,150 Euros, RDP =21,219 Euros, P=0.02). Conclusions: Cost-effective results of RDP seem to be similar to LDP with some better short-term outcomes.
