Evidence map›Paper›PMID 39164438›Full record

ArticleSurgical endoscopy2024

Nationwide cost-effectiveness and quality of life analysis of minimally invasive distal pancreatectomy.

Matteo De Pastena, Alessandro Esposito, Salvatore Paiella, Greta Montagnini, Caterina C Zingaretti, Marco Ramera, Danila Azzolina, Dario Gregori, Emanuele F Kauffmann, Alessandro Giardino and 4 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Matteo De PastenaGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.ORCID 0000-0001-5244-4357
Alessandro EspositoGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Salvatore PaiellaGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Greta MontagniniGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Caterina C ZingarettiGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Marco RameraGeneral and Pancreatic Surgery Department, Pancreas Institute, University and Hospital Trust of Verona, Verona, Italy.
Danila AzzolinaDepartment of Environmental and Preventive Science, University of Ferrara, Ferrara, Italy.
Dario GregoriUnit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova, Padova, Italy.
Emanuele F KauffmannDivision of General and Transplant Surgery, Pisa University Hospital, Pisa, Italy.
Alessandro GiardinoHPB Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
Luca MoraldiDivision of Oncologic Surgery and Robotics, Department of Oncology, Careggi University Hospital, Florence, Italy.
Giovanni ButturiniHPB Surgery Unit, Pederzoli Hospital, Peschiera del Garda, Verona, Italy.
Ugo BoggiDivision of General and Transplant Surgery, Pisa University Hospital, Pisa, Italy.
Roberto SalviaUniversity of Verona, Verona, Italy. roberto.salvia@univr.it.

Funding

Intuitive Foundation Grant 2021
6 · The paper itself

Abstract

backgroundThis study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP).

methodsConsecutive patients submitted to LDP or RDP from 2010 to 2020 in four high-volume Italian centers were included, with a minimum of 12 months of postoperative follow-up were included. QoL was evaluated using the EORTC QLQ-C30 and EQ-5D questionnaires, self-reported by patients. After a propensity score matching, which included BMI, gender, operation time, multiorgan and vascular resections, splenic preservation, and pancreatic stump management, the mean differential cost and Quality-Adjusted Life Years (QALY) were calculated and plotted on a cost-utility plane.

resultsThe study population consisted of 564 patients. Among these, 271 (49%) patients were submitted to LDP, while 293 (51%) patients to RDP. After propensity score matching, the study population was composed of 159 patients in each group, with a median follow-up of 59 months. As regards the QoL analysis, global health and emotional functioning domains showed better results in the RDP group (p = 0.037 and p = 0.026, respectively), whereas the other did not differ. As expected, the median crude costs analysis confirmed that RDP was more expensive than LDP (16,041 Euros vs. 10,335 Euros, p < 0.001). However, the robotic approach had a higher probability of being more cost-effective than the laparoscopic procedure when a willingness to pay more than 5697 Euros/QALY was accepted.

conclusionRDP was associated with better QoL as explored by specific domains. Crude costs were higher for RDP, and the cost-effectiveness threshold was set at 5697 euros/QALY.

Indexed as

Cost-Benefit AnalysisLaparoscopyPancreatectomyQuality of LifeRobotic Surgical ProceduresAdultAgedFemaleHumansItalyMaleMiddle AgedPancreatic NeoplasmsPropensity ScoreQuality-Adjusted Life YearsRetrospective StudiesCost analysisLaparoscopic distal pancreatectomyMinimally invasive pancreatectomyPancreatic surgeryRobotic distal pancreatectomy

Identifiers

PMID39164438
PMCPMC11458716

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.