Hospital cost and clinical effectiveness of robotic-assisted versus video-assisted thoracoscopic and open lobectomy: A propensity score-weighted comparison

The Journal of Thoracic and Cardiovascular Surgery
Peter J KneuertzRobert E Merritt

Abstract

To compare cost and perioperative outcomes of robotic, video-assisted thoracoscopic surgery (VATS), and open surgical approaches to pulmonary lobectomy. Patients who underwent pulmonary lobectomy between 2012 and 2017 at a single tertiary referral center were reviewed. Propensity score adjustment by inverse probability of treatment weighting (IPTW) was used to balance baseline patient characteristics. The primary outcomes of the study were direct hospital cost and perioperative outcomes, including operative time, complications rates, and length of stay. Indirect cost and charges were secondary financial outcomes. A total of 697 patients underwent pulmonary lobectomy by robotic (n = 296), VATS (n = 161), and open thoracotomy (n = 240). In the IPTW-adjusted analysis, open thoracotomy had the shortest mean operating room time (robotic 278 minutes vs VATS 298 minutes vs open 265 minutes, P = .05), and lowest operating room costs (robotic $9,912 vs VATS $9491 vs open $8698, P = .001). Length of stay was significantly shorter after robotic and VATS lobectomy (robotic 3.8 days vs VATS 3.8 days vs open 5.4 days, P < .001), with significantly fewer events of atelectasis and pneumonia as compared with the open group. In sum, no significa...Continue Reading

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Citations

Sep 19, 2019·JAMA Surgery·M Blair Marshall, Jon O Wee
May 22, 2020·Current Geriatrics Reports·George Mois, Jenay M Beer
Mar 5, 2020·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Jefferson Luiz Gross
Jun 10, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Thorben MöllerJan-Hen Drik Egberts
Oct 27, 2020·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·Thorben Möller, Jan-Hendrik Egberts
Jan 20, 2021·The Journal of Thoracic and Cardiovascular Surgery·Yajie ZhangHecheng Li
Mar 31, 2021·Zentralblatt für Chirurgie·Danjouma CheufouServet Bölükbas
Mar 9, 2019·The Journal of Thoracic and Cardiovascular Surgery·Robert B Cameron
Dec 15, 2020·The Journal of Surgical Research·Adwaiy ManerikarAnkit Bharat
Nov 25, 2020·The Annals of Thoracic Surgery·Burak Onan, Ismihan Selen Onan
Jun 12, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Pierre-Emmanuel FalcozAnne Charloux
Jul 29, 2021·JTCVS Techniques·Prabhu SasankanRobert Cerfolio
Aug 6, 2021·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Luis J HerreraJuan C Escalon
Aug 17, 2021·Current Anesthesiology Reports·Javier H Campos, Dionne Peacher
Dec 22, 2020·The Journal of Thoracic and Cardiovascular Surgery·Elliot L Servais
Aug 15, 2021·The Annals of Thoracic Surgery·Travis C GeraciRobert J Cerfolio
Aug 15, 2021·The Annals of Thoracic Surgery·Brendan T HeidenBenjamin D Kozower

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