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Cost-effectiveness and quality of life analysis of laparoscopic and robotic distal pancreatectomy: a propensity score-matched study

机译：腹腔镜和机器人远端胰腺切除术的成本效益和生活质量分析：倾向分数匹配研究

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摘要

Background This study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP). Method All patients who underwent LDP or RDP from 2011 to 2017 and with a minimum postoperative follow-up of 12 months were included in the study. To minimize bias, a propensity score-matched analysis (1:2) was performed. Two different questionnaires (EORTC QLQ-C30 and EQ-5D) were completed by the patients. The mean differential cost and mean differential Quality Adjusted Life Years (QALY) were calculated and plotted on a cost-utility plane. Results The study population consisted of 152 patients. After having applied the propensity score matching, the final population included 103 patients divided into RDP group (n = 37, 36%) and LDP (n = 66, 64%). No differences were found between groups regarding the baseline, intraoperative, postoperative, and pathological variables (p > 0.05). The QoL analysis showed a significant improvement in the RDP group on the postoperative social function, nausea, vomiting, and financial status (p = 0.010, p = 0.050, and p = 0.030, respectively). As expected, the crude costs analysis confirmed that RDP was more expensive than LDP (12,053 Euros vs. 5519 Euros, p < 0.001). However, the robotic approach had a higher probability of being more cost-effective than the laparoscopic procedure when a willingness to pay of more than 4800 Euros/QALY was accepted. Conclusion RDP was associated with QoL improvement in specific domains. Crude costs were higher relative to LDP. Cost-effectiveness threshold resulted to be 4800 euros/QALY. The increasing worldwide diffusion of the robotic technology, with easier access and possible cost reduction, could increase the sustainability of this procedure.
机译：背景本研究分析了腹腔镜（LDP）与机器人远端胰腺切除术（RDP）的生活质量（QoL）和成本效益。方法所有在2011年至2017年间接受LDP或RDP治疗且术后至少随访12个月的患者均纳入本研究。为了减少偏差，进行了倾向评分匹配分析（1:2）。患者填写了两份不同的问卷（EORTC QLQ-C30和EQ-5D）。计算平均差异成本和平均差异质量调整寿命年（QALY），并绘制在成本效用平面上。结果研究人群包括152名患者。应用倾向评分匹配后，最终的人群包括103名患者，分为RDP组（n=37,36%）和LDP组（n=66,64%）。两组在基线检查、术中、术后和病理变量方面均无差异（p>0.05）。生活质量分析显示，RDP组在术后社会功能、恶心、呕吐和财务状况方面有显著改善（分别为p=0.010、p=0.050和p=0.030）。正如预期的那样，原油成本分析证实RDP比LDP更贵（12053欧元对5519欧元，p<0.001）。然而，如果愿意支付超过4800欧元/QALY的费用，机器人手术比腹腔镜手术更具成本效益。结论RDP与特定领域的生活质量改善有关。与自民党相比，原油成本更高。成本效益阈值为4800欧元/QALY。机器人技术在世界范围内的日益普及，以及更容易获取和可能降低的成本，可能会增加这一过程的可持续性。

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  • 来源
    《Surgical Endoscopy》 |2021年第3期|共9页
  • 作者

    De Pastena Matteo; Esposito Alessandro; Paiella Salvatore; Surci Niccolo; Montagnini Greta; Marchegiani Giovanni; Malleo Giuseppe; Secchettin Erica; Casetti Luca; Claudio Ricci; Landoni Luca; Bovo Chiara; Bassi Claudio; Salvia Roberto;

  • 作者单位

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ Bologna S Orsola Malpighi Hosp Dept Med &

    Surg Sci DIMEC Alma Mater Studiorum Bologna;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    AOUI Verona Italy;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

    Univ &

    Hosp Trust Verona Pancreas Inst Gen &

    Pancreat Surg Dept Policlin GB Rossi Piazzale LA;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    Robotic surgery; Cost analysis; Minimally invasive pancreatectomy; Laparoscopic pancreatectomy; Quality of life analysis;

    机译：机器人手术;成本分析;微创胰腺切除术;腹腔镜胰腺切除术;生活质量分析;

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