Robotic-assisted radical cystectomy resulted in fewer deaths, higher cost

Issue: May 25, 2012

Although robotic-assisted radical cystectomy for bladder cancer resulted in fewer deaths and overall complications, it cost more than traditional surgery and did not shorten hospital stays, according to the results of a retrospective, observational cohort study.

Researchers identified patients from the US Healthcare Cost and Utilization Project Nationwide Inpatient Sample who had undergone radical cystectomy with (n=224) or without robotic assistance (n=1,444). They then looked at in-patient deaths, complications, length of hospital stays and cost for the two procedures.

A greater percentage of robotic-assisted surgeries were performed at teaching hospitals (P<.001). They also accounted for a larger proportion of radical cystectomies at small hospitals compared with larger hospitals.

Data indicated that patients who underwent robotic-assisted surgery had fewer deaths than traditional surgery (0% vs. 2.5%; P<.001) and fewer overall complications (49.1% vs. 63.8%; P=.035). In addition, those patients who underwent robotic-assisted surgery also less frequently required parenteral nutrition compared with those who underwent traditional surgery (6.4% vs. 13.3%; P=.046).

Routine length of hospital stay was similar between the two groups.

The total cost of robotic-assisted surgery was $3,000 greater than traditional surgery (median $28,100 vs. $24,303; P=.023).

The researchers said previous reports of outcomes from robotic-assisted surgery have come from single medical centers and have not included direct comparisons to traditional surgery. However, perioperative mortality from this procedure may be greater in a study with a larger patient sampling.

References:

Yu H. European Urology. 2012;61:1239-1244.