| アブストラクト | OBJECTIVE: To evaluate in-hospital fees and surgical outcomes of robot-assisted radical cystectomy (RARC), laparoscopic radical cystectomy (LRC) and open radical cystectomy (ORC) using a Japanese nationwide database. METHODS: All data were obtained from the Diagnosis Procedure Combination database between April 2020 and March 2022. Basic characteristics and perioperative indicators, including in-hospital fees, were compared among the RARC, LRC and ORC groups. Propensity score-matched comparisons were performed to assess the differences between RARC and ORC. RESULTS: During the study period, 2931, 1311 and 2435 cases of RARC, LRC and ORC were identified, respectively. The RARC group had the lowest in-hospital fee (median: 2.38 million yen), the shortest hospital stay (26 days) and the lowest blood transfusion rate (29.5%), as well as the lowest complication rate (20.9%), despite having the longest anesthesia time (569 min) among the three groups (all P < 0.01). The outcomes of LRC were comparable with those of RARC, and the differences in these indicators between the RARC and ORC groups were greater than those between the RARC and LRC groups. In propensity score-matched comparisons between the RARC and ORC groups, the differences in the indicators remained significant (all P < 0.01), with an ~50 000 yen difference in in-hospital fees. CONCLUSIONS: RARC and LRC were considered to be more cost-effective surgeries than ORC due to their superior surgical outcomes and comparable surgical fees in Japan. The widespread adoption of RARC and LRC is expected to bring economic benefits to Japanese society. |
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| ジャーナル名 | Japanese journal of clinical oncology |
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| Pubmed追加日 | 2024/3/30 |
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| 投稿者 | Yokoyama, Minato; Chen, Wei; Waseda, Yuma; Fujiwara, Motohiro; Kato, Daisuke; Shirakawa, Takeshi; Shimizu, Yohei; Nenohi, Tsunehiro; Matsumoto, Yuki; Okumura, Taisuke; Urushibara, Masayasu; Ai, Masumi; Fushimi, Kiyohide; Fukagai, Takashi; Eto, Masatoshi; Fujii, Yasuhisa; Ishizaka, Kazuhiro |
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| 組織名 | Department of Urology, Teikyo University Hospital, Mizonokuchi, Kawasaki City.;Department of Insured Medical Care Management, Tokyo Medical and Dental;University, Tokyo.;Department of Urology, Tokyo Medical and Dental University, Tokyo.;Department of Health Policy and Informatics, Tokyo Medical and Dental University,;Tokyo.;Department of Urology, Showa University School of Medicine, Tokyo.;Department of Urology, Graduate School of Medical Sciences, Kyushu University,;Fukuoka, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38553780/ |
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