Annual nationwide analysis of costs and post-operative outcomes after radical prostatectomy according to the surgical approach (open, laparoscopic, and robotic) - MULTIGNER-QUENEL - Evaluation des expositions et recherche épidémiologique sur l'environnement, la reproduction et le développement (3ERD) Accéder directement au contenu
Article Dans Une Revue World Journal of Urology Année : 2022

Annual nationwide analysis of costs and post-operative outcomes after radical prostatectomy according to the surgical approach (open, laparoscopic, and robotic)

Annabelle Grabia
  • Fonction : Auteur
Eric Barret
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  • PersonId : 1116883
Raphaele Renard-Penna
  • Fonction : Auteur
  • PersonId : 997564
Guilhem Roubaud
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  • PersonId : 975634
Paul Sargos
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  • PersonId : 1042270
Charles-Edouard Lequeu
  • Fonction : Auteur

Résumé

Objective Annual countrywide data are scarce when comparing surgical approaches in terms of hospital stay outcomes and costs for radical prostatectomy (RP). We aimed to assess the impact of surgical approach on post-operative outcomes and costs after RP by comparing open (ORP), laparoscopic (LRP), and robot-assisted (RARP) RP in the French healthcare system. Patients and methods Data from all patients undergoing RP in France in 2020 were extracted from the central database of the national healthcare system. Primary endpoints were length of hospital stay (LOS including intensive care unit (ICU) stay if present), complications (estimated by severity index), hospital readmission rates (at 30 and 90 days), and direct costs of initial stay. Results and limitations A total of 19,018 RPs were performed consisting in ORP in 21.1%, LRP in 27.6%, and RARP in 51.3% of cases. RARP was associated with higher center volume (p < 0.001), lower complication rates (p < 0.001), shorter LOS (p < 0.001), and lower readmission rates (p = 0.004). RARP was associated with reduced direct stay costs (2286 euros) compared with ORP (4298 euros) and LRP (3101 euros). The main cost driver was length of stay. The main limitations were the lack of mid-term data, readmission details, and cost variations due to surgery system. Conclusions This nationwide analysis demonstrates the benefits of RARP in terms of post-operative short-term outcomes. Higher costs related to the robotic system appear to be balanced by patient care improvements and reduced direct costs due to shorter LOS.
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Dates et versions

hal-03476704 , version 1 (13-12-2021)

Identifiants

Citer

Guillaume Ploussard, Annabelle Grabia, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, et al.. Annual nationwide analysis of costs and post-operative outcomes after radical prostatectomy according to the surgical approach (open, laparoscopic, and robotic). World Journal of Urology, 2022, 40 (2), pp.419-425. ⟨10.1007/s00345-021-03878-0⟩. ⟨hal-03476704⟩
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