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The European Journal of Health Economics

Erschienen in:

19.03.2021 | Original Paper

Economic analysis of open versus laparoscopic versus robotic hepatectomy: a systematic review and meta-analysis

verfasst von: Ioannis A. Ziogas, Alexandros P. Evangeliou, Konstantinos S. Mylonas, Dimitrios I. Athanasiadis, Panagiotis Cherouveim, David A. Geller, Richard D. Schulick, Sophoclis P. Alexopoulos, Georgios Tsoulfas

Erschienen in: The European Journal of Health Economics | Ausgabe 4/2021

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Abstract

Background

Following the publication of reports from landmark international consensuses (Louisville 2008 and Morioka 2014), minimally invasive hepatectomy became widely accepted as a legitimate alternative to open surgery. We aimed to compare the operative, hospitalization, and total economic costs of open (OLR) vs. laparoscopic (LLR) vs. robotic liver resection (RLR).

Methods

We performed a systematic literature review (end-of-search date: July 3, 2020) according to the PRISMA statement. Random-effects meta-analyses were conducted. Quality assessment was performed with the Cochrane Risk of Bias tool for randomized controlled trials, and the Newcastle–Ottawa Scale for non-randomized studies.

Results

Thirty-eight studies reporting on 3847 patients (1783 OLR; 1674 LLR; 390 RLR) were included. The operative costs of LLR were significantly higher than those of OLR, while subgroup analysis also showed higher operative costs in the LLR group for major hepatectomy, but no statistically significant difference for minor hepatectomy. Hospitalization costs were significantly lower in the LLR group, with subgroup analyses indicating lower costs for LLR in both major and minor hepatectomy series. No statistically significant difference was observed regarding total costs between LLR and OLR both overall and on subgroup analyses in either major or minor hepatectomy series. Meta-analyses showed higher operative, hospitalization, and total costs for RLR vs. LLR, but no statistically significant difference regarding total costs for RLR vs. OLR.

Conclusion

LLR’s higher operative costs are offset by lower hospitalization costs compared to OLR leading to no statistically significant difference in total costs, while RLR appears to be a more expensive alternative approach.

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Titel: Economic analysis of open versus laparoscopic versus robotic hepatectomy: a systematic review and meta-analysis
verfasst von: Ioannis A. Ziogas
Alexandros P. Evangeliou
Konstantinos S. Mylonas
Dimitrios I. Athanasiadis
Panagiotis Cherouveim
David A. Geller
Richard D. Schulick
Sophoclis P. Alexopoulos
Georgios Tsoulfas
Publikationsdatum: 19.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: The European Journal of Health Economics / Ausgabe 4/2021
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI: https://doi.org/10.1007/s10198-021-01277-1

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Zur Zeit gratis
COVID-19
Original Paper

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Economic analysis of open versus laparoscopic versus robotic hepatectomy: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

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Conclusion

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