SP3.12 Cost effectiveness of robotic versus laparoscopic colorectal resections: a mapped systematic review of published studies

Abstract

Abstract Objective Robotic colorectal resections (RCR) have been gaining popularity recently due to several advantages in addition to the oncological safety. The objective of this review to evaluate the cost effectiveness of RCR compared to laparoscopic colorectal resection (LCR). Materials and methods All types of comparative studies reporting the cost of RCR versus LCR were retrieved from the search of standard medical electronic databases and analysis was conducted by using the principles of meta-analysis on the statistical software RevMan version 5. Results The search of medical databases yielded 14 comparative studies (one randomised trial and 13 retrospective studies) on 17961 patients undergoing oncological and non-oncological colorectal resections. Thirteen studies reported total cost whereas 7 studies reported only operative cost. In the random effects model analysis, LCR was associated with the reduced total cost [standardised mean difference -91.35, 95%, CI (-104.91, -77.80), Z = 13.21, P=0.00001] as well as reduced operative cost [standardised mean difference -4.75, 95%, CI (-9.09, -3.40), Z = 6.93, P=0.00001] compared to RCR. However, there was significant heterogeneity (Tau2 = 2.95; Chi2 = 902.27, df = 12; (p < 0.00001; I2 = 99%) among included studies. Conclusion The LCR seems to be more cost effective compared to RCR in terms of operative cost as well as total cost (operative plus in-patient stay). However, due to statistically significant heterogeneity among included studies and paucity of the randomised trials, these findings should be taken cautiously.