Intracorporeal Versus Extracorporeal Anastomosis in Robotic Right Colectomy: A Multicenter, Triple-blind, Randomized Clinical Trial.

Autor:	Dohrn N; Department of Surgery, Copenhagen University Hospital - Herlev & Gentofte, Denmark.; Center for Surgical Science, Zealand University Hospital Koege, Denmark; and., Yikilmaz H; Center for Surgical Science, Zealand University Hospital Koege, Denmark; and., Laursen M; Department of Surgery, Copenhagen University Hospital - Herlev & Gentofte, Denmark., Khesrawi F; Center for Surgical Science, Zealand University Hospital Koege, Denmark; and., Clausen FB; Department of Surgery, Copenhagen University Hospital - Herlev & Gentofte, Denmark., Sørensen F; Department of Statistics, University of oxford, United Kingdom., Jakobsen HL; Department of Surgery, Copenhagen University Hospital - Herlev & Gentofte, Denmark., Brisling S; Center for Surgical Science, Zealand University Hospital Koege, Denmark; and., Lykke J; Department of Surgery, Copenhagen University Hospital - Herlev & Gentofte, Denmark., Eriksen JR; Center for Surgical Science, Zealand University Hospital Koege, Denmark; and., Klein MF; Department of Surgery, Copenhagen University Hospital - Herlev & Gentofte, Denmark., Gögenur I; Center for Surgical Science, Zealand University Hospital Koege, Denmark; and.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2022 Nov 01; Vol. 276 (5), pp. e294-e301. Date of Electronic Publication: 2021 Oct 13.
DOI:	10.1097/SLA.0000000000005254
Abstrakt:	Objective: To determine if minimally invasive right colectomy with intra-corporeal anastomosis improves postoperative recovery compared to extra-corporeal anastomosis. Background: Previous trials have shown that intracorporeal anastomosis improves postoperative recovery; however, it has not yet been evaluated in a setting with optimized perioperative care or with patient-related outcome measures. Methods: This was a multicenter, triple-blind, randomized clinical trial at two high-volume colorectal centers with strict adherence to optimized perioperative care pathways. The patients underwent robotic right colectomy with either intracorporeal or extracorporeal anastomosis. The primary outcome was patient-reported postoperative recovery measured using the "Quality of Recovery-15" questionnaire. ClinicalTrials.gov NCT03130166. Results: A total of 89 patients were randomized and analyzed according to the "Intention-to-treat"-principle. We found no statistically significant differences in patient-reported recovery between the groups. Postoperative pain, nausea, time to ambulation, time to first passage of flatus/stool, length of hospital stay, and pathophysiological tests showed no differences either. The duration of time to create the anastomosis was significantly longer with intracorporeal anastomosis (17 vs 13 min, P = 0.003), while all other intraoperative, postoperative, and pathology variables showed no difference. Conclusion: There were no significant differences in postoperative recovery between the two groups. Competing Interests: Conflicts of Interest and Sources of Funding: ND received unrestricted funding from the Louis-Hansen Foundation, Jacob & Olga Madsen’s foundation, Trigon Foundation, Toyota Foundation, Dagmar Marshalls Foundation, Vissing Foundation, the Kjaer Foundation, and the Nyegaard Foundation. The funding sources had no role in the design and conduct of the study; data collection, analysis, and interpretation of data; the preparation, review or approval of the manuscript or the decision to submit for publication. For the remaining authors none were declared. The study did not receive funding from National Institutes of Health (NIH); Wellcome Trust; or Howard Hughes Medical Institute (HHMI). The authors report no conflicts of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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