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

作者：Lei Ma, Ruihan Liu, Chenhao Hu, Lei Zhang, Penghong Qu, Junjun She · 发表于：Surgical Endoscopy · 年份：2025 · DOI：10.1007/s00464-025-11775-5 · 被引用次数：3 · 研究领域：Gastrointestinal Tumor Research and Treatment、Gastrointestinal disorders and treatments、Minimally Invasive Surgical Techniques

BACKGROUND: Robotic 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. METHODS: This 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. RESULTS: After 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 co...