Objectives: The aim of this study is to perform a comparative costs analysis of radical retropubic prostatectomy (RRP) and robotic-assisted laparoscopic prostatectomy (RAP) for clinically localized prostate cancer and to determine whether to expand the use of RAP or to continue with conventional RRP in Teaching Hospital San Giovanni Battista Turin Italy. Methods: A cohort study was carried out comprising consecutive patients undergoing radical prostatectomy. The decision of which surgical approach to use was by patient choice after a discussion of the perceived pros and cons of each alternative. No other selection criteria were routinely used. All patients were followed on a common care pathway. Included in the assessment model were the following domains (EUnetHTA): Safety, Clinical effectiveness, Organizational aspects, Cost and economic evaluation. Data were collected from the patient's medical health record and the operating room report and data were obtained from the hospital accounting office. Two-way sensitivity analysis of RAP was performed. Results: In agreement with other observations our results showed that the mean LOS for RAPtreated patients was shorter and that LOS in the ICU was longer as well as the operating time. RAP is more expensive than RRP. Conclusion: In the current circumstances, increasing the use of RAP at the San Giovanni Battista Hospital does not appear expedient. This conclusion is corroborated by the sensitivity analysis which showed that RAP carries higher costs than RRP.
Robot-assisted radical prostatectomy: A minihealth technology assessment in a teaching hospital
MARTIN, Barbara;CHARRIER, Lorena;BERT, Fabrizio;GIANINO, Maria Michela
2012-01-01
Abstract
Objectives: The aim of this study is to perform a comparative costs analysis of radical retropubic prostatectomy (RRP) and robotic-assisted laparoscopic prostatectomy (RAP) for clinically localized prostate cancer and to determine whether to expand the use of RAP or to continue with conventional RRP in Teaching Hospital San Giovanni Battista Turin Italy. Methods: A cohort study was carried out comprising consecutive patients undergoing radical prostatectomy. The decision of which surgical approach to use was by patient choice after a discussion of the perceived pros and cons of each alternative. No other selection criteria were routinely used. All patients were followed on a common care pathway. Included in the assessment model were the following domains (EUnetHTA): Safety, Clinical effectiveness, Organizational aspects, Cost and economic evaluation. Data were collected from the patient's medical health record and the operating room report and data were obtained from the hospital accounting office. Two-way sensitivity analysis of RAP was performed. Results: In agreement with other observations our results showed that the mean LOS for RAPtreated patients was shorter and that LOS in the ICU was longer as well as the operating time. RAP is more expensive than RRP. Conclusion: In the current circumstances, increasing the use of RAP at the San Giovanni Battista Hospital does not appear expedient. This conclusion is corroborated by the sensitivity analysis which showed that RAP carries higher costs than RRP.
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