A national, multi-institutional database study found readmission and complication rates were significantly lower for robotic-assisted prostate surgery than for open prostate surgery.1 The full study results were published in the November 19 electronic edition of the Journal of Endourology.
"Readmissions for Medicare patients alone currently add $17.4 billion each year in health care spending," said Lead Investigator Robert Nadler MD, Northwestern Medicine Vice Chair of Urology. "The findings from this study show that beyond the patient benefit, robotic-assisted surgery may be relevant to reducing health care costs as it results in reduced readmission rates compared to open surgery."
This retrospective study used the National Surgical Quality Improvement (NSQIP) database to analyze data on patients who received a prostatectomy in 2011. A total of 5,471 patients and more than 400 hospitals were included in the study. Of those patients, 1,097 (20 percent) had an open procedure and 4,374 (80 percent) had a minimally invasive robotic-assisted procedure. No patients had a laparoscopic procedure.
Overall, the robotic-assisted group experienced significantly lower overall complication rates, surgical complication rates, and unplanned readmission rates. Although the operative time was significantly longer for the robotic-assisted group than for the open group, this did not result in higher complications during or after surgery. A full comparison between the two procedures showed:1
|Robotic-assisted Prostatectomy (n=4374)||Open Prostatectomy (n=1097)|
|Overall Complication Rate (p<0.001)*||5.62%||23.25%|
|Surgical Complication Rate (p<0.001)*||0.91%||3.37%|
|Unplanned Readmission Rate (p=0.002)*||3.48%||5.47%|
|Operative Time (p=0.001)*||212.3 minutes||174.0 minutes|
|*p<0.05 denotes a statistically significant value.|
Because this was a retrospective study, the researchers could not factor in certain variables, such as patient selection bias and co-morbidities (other illnesses that could affect the outcomes of the patient's surgery). The only lifestyle variables included in the analysis were smoking and alcohol use.
1 Pilecki MA, McGuire BB, Jain UK, et al. National multi-institutional comparison of 30-day post-operative complication and re-admission rates between open retropubic radical prostatectomy (RRP) and robot-assisted laparoscopic prostatectomy (RALRP) using NSQIP. J Endourol. 2013 Nov 19. [Epub ahead of print].