Evidence map›Paper›PMID 40360899›Full record

ArticleSurgical endoscopy2025

Clinical outcomes and cost-effectiveness analysis of robotic and endoscopic cooperative surgery for treating gastric submucosal tumors: a longitudinal nested cohort study.

Lei Ma, Ruihan Liu, Chenhao Hu, Lei Zhang, Penghong Qu, Junjun She

Abstract readComparative Study
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. 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

6 authors.

Lei MaDepartment of General Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
Ruihan LiuDepartment of General Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
Chenhao HuDepartment of General Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
Lei ZhangDepartment of General Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
Penghong QuDepartment of General Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
Junjun SheDepartment of General Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi, China. junjunshe1975@sina.com.ORCID http://orcid.org/0000-0001-5104-663X

Funding

National Natural Science Foundation of China No. 81870380
6 · The paper itself

Abstract

backgroundRobotic and endoscopic cooperative surgery (RECS) is an emerging and promising therapeutic approach for treating gastric submucosal tumors (GSMTs). However, the efficacy of RECS has not been well established, and its high medical costs significantly limit its application.

methodsThis nested cohort study examined patients with GSMTs managed with different surgical techniques. A total of 314 consecutive patients were enrolled in this study, including 61 patients treated with RECS, 196 patients treated laparoscopically, and 57 patients treated with open surgery. To mitigate confounding bias, 1:1:1 propensity score matching (PSM) was utilized. The perioperative outcomes, postoperative gastrointestinal symptoms, long-term outcomes, and cost-effectiveness among the three groups were compared.

resultsAfter PSM, 51 patients were included in each group. Compared with the laparoscopic and open surgical groups, the RECS group presented significantly lower intraoperative bleeding volumes, times to first flatus, times to liquid intake, and postoperative hospital stay. The severity of gastrointestinal symptoms in the RECS group was notably better than that in the laparoscopic and open groups 3, 6, and 12 months postsurgery. Regarding long-term outcomes, there were no differences in overall or relapse-free survival among the three groups. The total hospitalization cost was significantly greater in the RECS group, primarily due to surgical cost differences. The incremental cost-effectiveness ratios per quality-adjusted life year for the RECS group relative to the laparoscopic and open groups were 18,244 and 56,914 Chinese yuan (CNY), respectively. Analysis of the cost-effectiveness acceptability curves indicated that across all willingness-to-pay thresholds, the probability that RECS was cost-effective exceeded 90%.

conclusionsRECS is a safe and effective method for treating GSMTs, offering faster postoperative recovery and fewer gastrointestinal symptoms than laparoscopic and open surgeries. Despite the increased costs associated with the introduction of RECS technology, it remains a cost-effective option.

Indexed as

Endoscopic Mucosal ResectionGastroscopyRobotic Surgical ProceduresStomach NeoplasmsAdultAgedCost-Benefit AnalysisCost-Effectiveness AnalysisFemaleHumansLaparoscopyLength of StayLongitudinal StudiesMaleMiddle AgedPostoperative ComplicationsClinical outcomesCost-effectiveness analysisGastric submucosal tumorsLaparoscopic surgeryOpen surgeryRobotic and endoscopic cooperative surgery

Identifiers

PMID40360899
PMCPMC12116666

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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.