TY - JOUR
T1 - Cost-analysis of robot-assisted radical cystectomy in Europe
T2 - A cross-country comparison
AU - Mjaess, Georges
AU - Diamand, Romain
AU - Aoun, Fouad
AU - Assenmacher, Gregoire
AU - Assenmacher, Christophe
AU - Verhoest, Gregory
AU - Holz, Serge
AU - Naudin, Michel
AU - Ploussard, Guillaume
AU - Mari, Andrea
AU - Tay, Andrea
AU - Issa, Rami
AU - Roumiguié, Mathieu
AU - Bajeot, Anne Sophie
AU - Umari, Paolo
AU - Sridhar, Ashwin
AU - Kelly, John
AU - Hendricksen, Kees
AU - Einerhand, Sarah
AU - Mertens, Laura S.
AU - Sanchez-Salas, Rafael
AU - Gallardo, Anna Colomer
AU - Quackels, Thierry
AU - Peltier, Alexandre
AU - Pradere, Benjamin
AU - Moschini, Marco
AU - Roumeguère, Thierry
AU - European Association of Urology - Young Academic Urologists (EAU-YAU), Urothelial Carcinoma Working Group
AU - Albisinni, Simone
N1 - Publisher Copyright: © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2022
Y1 - 2022
N2 - Background: Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is surging worldwide. Aim of the study was to perform a multicentric cost-analysis of RARC by comparing the gross cost of the intervention across hospitals in four different European countries. Methods: Patients who underwent RARC + ICUD were recruited from eleven European centers in four European countries (Belgium, France, Netherlands, and UK) between 2015 and 2020. Costs were divided into six parts: cost for hospital stay, cost for ICU stay, cost for surgical theater occupation, cost for transfusion, cost for robotic instruments, and cost for stapling instruments. These costs were individually assessed for each patient. Results: A total of 490 patients were included. Median operative time was 300(270–360) minutes and median hospital length-of-stay was 11(8–15) days. The average total cost of RARC was 14.794€ (95%CI 14.300–15.200€). A significant difference was found for the total cost, as well as the various subcosts abovementioned, between the four included countries. Different sets and types of robotic instruments were used by each center, leading to a difference in cost of robotic instrumentation. Nearly 84% of costs of RARC were due to hospital stay (42%), ICU stay (3%) and operative time (39%), while 16% of costs were due to robotic (8%) and stapling (8%) instruments. Conclusion: Costs and subcosts of RARC + ICUD vary significantly across European countries and are mainly dependent of hospital length-of-stay and operative time rather than robotic instrumentation. Decreasing length-of-stay and reducing operative time could help to decrease the cost of RARC and make it more widely accessible.
AB - Background: Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is surging worldwide. Aim of the study was to perform a multicentric cost-analysis of RARC by comparing the gross cost of the intervention across hospitals in four different European countries. Methods: Patients who underwent RARC + ICUD were recruited from eleven European centers in four European countries (Belgium, France, Netherlands, and UK) between 2015 and 2020. Costs were divided into six parts: cost for hospital stay, cost for ICU stay, cost for surgical theater occupation, cost for transfusion, cost for robotic instruments, and cost for stapling instruments. These costs were individually assessed for each patient. Results: A total of 490 patients were included. Median operative time was 300(270–360) minutes and median hospital length-of-stay was 11(8–15) days. The average total cost of RARC was 14.794€ (95%CI 14.300–15.200€). A significant difference was found for the total cost, as well as the various subcosts abovementioned, between the four included countries. Different sets and types of robotic instruments were used by each center, leading to a difference in cost of robotic instrumentation. Nearly 84% of costs of RARC were due to hospital stay (42%), ICU stay (3%) and operative time (39%), while 16% of costs were due to robotic (8%) and stapling (8%) instruments. Conclusion: Costs and subcosts of RARC + ICUD vary significantly across European countries and are mainly dependent of hospital length-of-stay and operative time rather than robotic instrumentation. Decreasing length-of-stay and reducing operative time could help to decrease the cost of RARC and make it more widely accessible.
KW - Bladder
KW - Cancer
KW - Cost-analysis
KW - Cystectomy
KW - Robotics
UR - http://www.scopus.com/inward/record.url?scp=85136777403&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejso.2022.07.023
DO - https://doi.org/10.1016/j.ejso.2022.07.023
M3 - Article
C2 - 35970622
SN - 0748-7983
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
ER -