Robotic surgery improves transfusion rate and perioperative outcomes using a broad implementation process and...

Area of Science:

• Urology
• Surgical Oncology
• Health Services Research

Background:

• Randomized trial data suggest similar transfusion rates for robotic and open prostatectomy.
• This study aimed to compare perioperative outcomes between robotic and open prostatectomy at a Canadian academic center.

Purpose of the Study:

• To compare perioperative outcomes, including transfusion rates, length of stay, and hospital costs, between robotic and open prostatectomy.
• To evaluate the safety and efficiency of robotic versus open surgical approaches for prostatectomy.

Main Methods:

• Retrospective review of 1606 prostatectomies (robotic and open) performed between 2009 and 2016.
• Data extracted from an administrative data warehouse included patient and operative factors, and perioperative outcomes.
• Comparison of baseline characteristics and outcomes between robotic and open surgical approaches, with transfusion during the index admission as the primary outcome.

Main Results:

• Robotic prostatectomy showed a significantly lower transfusion rate (0.6% vs. 11.2%; p<0.001) compared to open surgery.
• Robotic surgery resulted in shorter recovery room (155.7 vs. 231.1 minutes; p<0.001) and hospital stays (1.4 vs. 2.8 days; p<0.001).
• Robotic prostatectomy incurred higher hospital costs per case ($11,475 vs. $10,656; p<0.001).

Conclusions:

• Robotic prostatectomy is associated with a lower transfusion rate compared to the open approach.
• The study highlights significant differences in length of stay and cost between the two surgical methods.
• Further research focusing on patient-reported outcomes is recommended to provide a comprehensive comparison.