Economic analysis of open versus laparoscopic versus robotic hepatectomy: a systematic review and meta-analysis

Ioannis A. Ziogas (), Alexandros P. Evangeliou, Konstantinos S. Mylonas, Dimitrios I. Athanasiadis, Panagiotis Cherouveim, David A. Geller, Richard D. Schulick, Sophoclis P. Alexopoulos and Georgios Tsoulfas
Additional contact information
Ioannis A. Ziogas: Vanderbilt University Medical Center
Alexandros P. Evangeliou: Surgery Working Group, Society of Junior Doctors
Konstantinos S. Mylonas: Surgery Working Group, Society of Junior Doctors
Dimitrios I. Athanasiadis: Surgery Working Group, Society of Junior Doctors
Panagiotis Cherouveim: Surgery Working Group, Society of Junior Doctors
David A. Geller: University of Pittsburgh Medical Center
Richard D. Schulick: University of Colorado Anschutz Medical Campus
Sophoclis P. Alexopoulos: Vanderbilt University Medical Center
Georgios Tsoulfas: Aristotle University of Thessaloniki School of Medicine

The European Journal of Health Economics, 2021, vol. 22, issue 4, No 8, 585-604

Abstract: Abstract Background Following the publication of reports from landmark international consensuses (Louisville 2008 and Morioka 2014), minimally invasive hepatectomy became widely accepted as a legitimate alternative to open surgery. We aimed to compare the operative, hospitalization, and total economic costs of open (OLR) vs. laparoscopic (LLR) vs. robotic liver resection (RLR). Methods We performed a systematic literature review (end-of-search date: July 3, 2020) according to the PRISMA statement. Random-effects meta-analyses were conducted. Quality assessment was performed with the Cochrane Risk of Bias tool for randomized controlled trials, and the Newcastle–Ottawa Scale for non-randomized studies. Results Thirty-eight studies reporting on 3847 patients (1783 OLR; 1674 LLR; 390 RLR) were included. The operative costs of LLR were significantly higher than those of OLR, while subgroup analysis also showed higher operative costs in the LLR group for major hepatectomy, but no statistically significant difference for minor hepatectomy. Hospitalization costs were significantly lower in the LLR group, with subgroup analyses indicating lower costs for LLR in both major and minor hepatectomy series. No statistically significant difference was observed regarding total costs between LLR and OLR both overall and on subgroup analyses in either major or minor hepatectomy series. Meta-analyses showed higher operative, hospitalization, and total costs for RLR vs. LLR, but no statistically significant difference regarding total costs for RLR vs. OLR. Conclusion LLR’s higher operative costs are offset by lower hospitalization costs compared to OLR leading to no statistically significant difference in total costs, while RLR appears to be a more expensive alternative approach.

Keywords: Open liver resection; Laparoscopic liver resection; Robotic liver resection; Economic cost; Systematic review; Meta-analysis (search for similar items in EconPapers)
JEL-codes: I10 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10198-021-01277-1 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:eujhec:v:22:y:2021:i:4:d:10.1007_s10198-021-01277-1

Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2

DOI: 10.1007/s10198-021-01277-1

Access Statistics for this article

The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().