A nationwide evaluation of robotic ventral hernia surgery.

Autor: Coakley KM; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA., Sims SM; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA., Prasad T; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA., Lincourt AE; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA., Augenstein VA; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA., Sing RF; Carolinas Medical Center, Division of Acute Care Surgery, Department of Surgery, Charlotte, NC, USA., Heniford BT; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA., Colavita PD; Carolinas Medical Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Charlotte, NC, USA. Electronic address: Paul.D.Colavita@carolinashealthcare.org.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2017 Dec; Vol. 214 (6), pp. 1158-1163. Date of Electronic Publication: 2017 Sep 20.
DOI: 10.1016/j.amjsurg.2017.08.022
Abstrakt: Background: The purpose of this study was to examine outcomes of robotic ventral hernia repair(RVHR) versus laparoscopic ventral hernia repair(LVHR).
Methods: The Nationwide Inpatient Sample was queried from October 2008 to December 2013 for ventral hernia repairs. Demographics, morbidity, mortality, and charges were compared between RVHR and LVHR.
Results: From 2008-2013, 149,622 ventral hernia surgeries were identified; 117,028 open, 32,243 laparoscopic, and 351 robotic. Open repairs were excluded. RVHR rose annually with 2013 containing 47.9% of all RVHRs. RVHR patients were more likely to be older and have more chronic conditions. There was no difference between length of stay. Pneumonia rates were higher with RVHR; however, after controlling for confounding variables, there was no difference in pneumonia rates. Mortality and other major complications were similar. Total charges were increased for RVHR in univariate and multivariate analysis. RVHR was more common in teaching hospitals and wealthier zip codes.
Conclusion: RVHR demonstrates comparable safety to the laparoscopic technique, with increased charges and increased volume in urban teaching hospitals and patients from areas of higher median income.
(Copyright © 2017 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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