Claire Perez, Lucas Weiser, Justin J Watson, Allen Razavi, Shruthi Nammalwar, Charles Fuller, Sevannah Soukiasian, Zishi Li, Raffaele Rocco, Andrew R Brownlee, Harmik J Soukiasian
{"title":"VATS与机器人解剖肺切除术在大容量机构:成本和结果分析。","authors":"Claire Perez, Lucas Weiser, Justin J Watson, Allen Razavi, Shruthi Nammalwar, Charles Fuller, Sevannah Soukiasian, Zishi Li, Raffaele Rocco, Andrew R Brownlee, Harmik J Soukiasian","doi":"10.1177/15569845251365679","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the impact of transitioning from video-assisted thoracoscopic surgery (VATS) to robot-assisted thoracoscopic surgery (RATS) on patient outcomes and costs, based on the experience of a single surgeon at a quaternary center.</p><p><strong>Methods: </strong>We reviewed patients who underwent anatomic lung resections by a single surgeon between 2015 and 2022, excluding nonanatomic resections and those involving robotic bronchoscopy followed by resection. We compared baseline characteristics, short-term outcomes, and costs between the VATS (2015 to 2018) and robotic (2018 to 2022) groups. Charges were adjusted to 2023 dollars for comparison across different time periods.</p><p><strong>Results: </strong>A total of 210 patients (140 robotic, 70 VATS) were analyzed, with no significant differences in baseline characteristics. Robotic surgery had a longer median procedure time (161 vs 145 min, <i>P</i> < 0.002). Length of stay was similar (5.3 ± 6.3 days for robotic vs 6.54 ± 7.5 days for VATS, <i>P</i> = 0.23), as were 30-day readmission rates (5% for robotic vs 5.7% for VATS, <i>P</i> = 0.83). Major complications occurred in 5 robotic and 5 VATS cases (<i>P</i> = 0.528). Adjusted direct charges were $40,250.40 (95% confidence interval [CI]: $34,739.0 to $45,761.8) for robotic and $44,124.00 (95% CI: $35,036.0 to $53,211.9) for VATS (<i>P</i> = 0.47). Total hospital charges were $74,199.00 (95% CI: $64,398.9 to $83,999.2) for robotic and $80,549.00 (95% CI: $63,028.9 to $98,069.3) for VATS (<i>P</i> = 0.498).</p><p><strong>Conclusions: </strong>Transitioning from VATS to RATS can be done safely without increasing costs or morbidity. In addition, the robotic approach demonstrated numerically lower charges, even during the surgeon's early learning curve. Hospital cost savings would be expected to increase as operative efficiency improves.</p>","PeriodicalId":13574,"journal":{"name":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","volume":" ","pages":"15569845251365679"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"VATS Versus Robotic Anatomic Pulmonary Resection in a High-Volume Institution: Cost and Outcomes Analysis.\",\"authors\":\"Claire Perez, Lucas Weiser, Justin J Watson, Allen Razavi, Shruthi Nammalwar, Charles Fuller, Sevannah Soukiasian, Zishi Li, Raffaele Rocco, Andrew R Brownlee, Harmik J Soukiasian\",\"doi\":\"10.1177/15569845251365679\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study evaluates the impact of transitioning from video-assisted thoracoscopic surgery (VATS) to robot-assisted thoracoscopic surgery (RATS) on patient outcomes and costs, based on the experience of a single surgeon at a quaternary center.</p><p><strong>Methods: </strong>We reviewed patients who underwent anatomic lung resections by a single surgeon between 2015 and 2022, excluding nonanatomic resections and those involving robotic bronchoscopy followed by resection. We compared baseline characteristics, short-term outcomes, and costs between the VATS (2015 to 2018) and robotic (2018 to 2022) groups. Charges were adjusted to 2023 dollars for comparison across different time periods.</p><p><strong>Results: </strong>A total of 210 patients (140 robotic, 70 VATS) were analyzed, with no significant differences in baseline characteristics. Robotic surgery had a longer median procedure time (161 vs 145 min, <i>P</i> < 0.002). Length of stay was similar (5.3 ± 6.3 days for robotic vs 6.54 ± 7.5 days for VATS, <i>P</i> = 0.23), as were 30-day readmission rates (5% for robotic vs 5.7% for VATS, <i>P</i> = 0.83). Major complications occurred in 5 robotic and 5 VATS cases (<i>P</i> = 0.528). Adjusted direct charges were $40,250.40 (95% confidence interval [CI]: $34,739.0 to $45,761.8) for robotic and $44,124.00 (95% CI: $35,036.0 to $53,211.9) for VATS (<i>P</i> = 0.47). Total hospital charges were $74,199.00 (95% CI: $64,398.9 to $83,999.2) for robotic and $80,549.00 (95% CI: $63,028.9 to $98,069.3) for VATS (<i>P</i> = 0.498).</p><p><strong>Conclusions: </strong>Transitioning from VATS to RATS can be done safely without increasing costs or morbidity. In addition, the robotic approach demonstrated numerically lower charges, even during the surgeon's early learning curve. Hospital cost savings would be expected to increase as operative efficiency improves.</p>\",\"PeriodicalId\":13574,\"journal\":{\"name\":\"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery\",\"volume\":\" \",\"pages\":\"15569845251365679\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/15569845251365679\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/15569845251365679","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
VATS Versus Robotic Anatomic Pulmonary Resection in a High-Volume Institution: Cost and Outcomes Analysis.
Objective: This study evaluates the impact of transitioning from video-assisted thoracoscopic surgery (VATS) to robot-assisted thoracoscopic surgery (RATS) on patient outcomes and costs, based on the experience of a single surgeon at a quaternary center.
Methods: We reviewed patients who underwent anatomic lung resections by a single surgeon between 2015 and 2022, excluding nonanatomic resections and those involving robotic bronchoscopy followed by resection. We compared baseline characteristics, short-term outcomes, and costs between the VATS (2015 to 2018) and robotic (2018 to 2022) groups. Charges were adjusted to 2023 dollars for comparison across different time periods.
Results: A total of 210 patients (140 robotic, 70 VATS) were analyzed, with no significant differences in baseline characteristics. Robotic surgery had a longer median procedure time (161 vs 145 min, P < 0.002). Length of stay was similar (5.3 ± 6.3 days for robotic vs 6.54 ± 7.5 days for VATS, P = 0.23), as were 30-day readmission rates (5% for robotic vs 5.7% for VATS, P = 0.83). Major complications occurred in 5 robotic and 5 VATS cases (P = 0.528). Adjusted direct charges were $40,250.40 (95% confidence interval [CI]: $34,739.0 to $45,761.8) for robotic and $44,124.00 (95% CI: $35,036.0 to $53,211.9) for VATS (P = 0.47). Total hospital charges were $74,199.00 (95% CI: $64,398.9 to $83,999.2) for robotic and $80,549.00 (95% CI: $63,028.9 to $98,069.3) for VATS (P = 0.498).
Conclusions: Transitioning from VATS to RATS can be done safely without increasing costs or morbidity. In addition, the robotic approach demonstrated numerically lower charges, even during the surgeon's early learning curve. Hospital cost savings would be expected to increase as operative efficiency improves.
期刊介绍:
Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery