A Comparison of Colectomy Outcomes Utilizing Open, Laparoscopic, and Robotic Techniques.

Autor:	McCarthy E; Christiana Care Surgical Residency Program, Newark, DE, USA., Gough BL; Christiana Care Surgical Residency Program, Newark, DE, USA., Johns MS; Christiana Care Surgical Residency Program, Newark, DE, USA., Hanlon A; Department of Statistics, Virginia Tech, Roanoke, VA, USA., Vaid S; Christiana Institute of Advanced Surgery, Newark, DE, USA., Petrelli N; Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2021 Aug; Vol. 87 (8), pp. 1275-1279. Date of Electronic Publication: 2020 Dec 19.
DOI:	10.1177/0003134820973384
Abstrakt:	Introduction: Robotic colectomy could reduce morbidity and postoperative recovery over laparoscopic and open procedures. This comparative review evaluates colectomy outcomes based on surgical approach at a single community institution. Methods: A retrospective review of all patients who underwent colectomy by a fellowship-trained colon and rectal surgeon at a single institution from 2015 through 2019 was performed, and a cohort developed for each approach (open, laparoscopic, and robotic). 30-day outcomes were evaluated. For dichotomous outcomes, univariate logistic regression models were used to quantify the individual effect of each predictor of interest on the odds of each outcome. Continuous outcomes received a similar approach; however, linear and Poisson regression modeling were used, as appropriate. Results: 115 patients were evaluated: 14% (n = 16) open, 44% (n = 51) laparoscopic, and 42% (n = 48) robotic. Among the cohorts, there was no statistically significant difference in operative time, rate of reoperation, readmission, or major complications. Robotic colectomies resulted in the shortest length of stay (LOS) (Kruskal-Wallis P < .0001) and decreased estimated blood loss (EBL) (Kruskal-Wallis P = .0012). Median age was 63 years (interquartile range [IQR] 53-72). 54% (n = 62) were female. Median American Society of Anesthesiologists physical status classification was 3 (IQR 2-3). Median body mass index was 28.67 (IQR 25.03-33.47). A malignant diagnosis was noted on final pathology in 44% (n = 51). Conclusion: Among the 3 approaches, there was no statistically significant difference in 30-day morbidity or mortality. There was a statistically significant decreased LOS and EBL for robotic colectomies.
Databáze:	MEDLINE
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