Association of robotic approach with patient-reported outcomes after pancreatectomy: a prospective cohort study.

Autor:	Liu JB; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Tam V; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; Department of Surgery, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA., Zenati MS; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Schwartz D; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Ali A; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Low CA; Departments of Medicine and Psychology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Smith LJ; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Zeh HJ 3rd; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA., Zureikat AH; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Hogg ME; Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA. Electronic address: mhogg@northshore.org.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2022 Oct; Vol. 24 (10), pp. 1659-1667. Date of Electronic Publication: 2022 Apr 26.
DOI:	10.1016/j.hpb.2022.04.008
Abstrakt:	Background: Robotic-assisted pancreatectomy continues to proliferate despite limited evidence supporting its benefits from the patient's perspective. We compared patient-reported outcomes (PROs) between patients undergoing robotic and open pancreatectomies. Methods: PROs, measured with the FACT-Hep, FACT-G, and HCS, were assessed in the immediate postoperative (i.e., preoperative to discharge) and recovery (i.e., discharge to three months postoperative) periods. Linear mixed models estimated the association of operative approach on PROs. Minimally important differences (MIDs) were also considered. Results: Among 139 patients, 105 (75.5%) underwent robotic pancreatectomies. Compared to those who underwent open operations, those who underwent robotic operations experienced worse FACT-Hep scores that were both statistically and clinically significant (mean difference [MD] 8.6 points, 95% CI 1.0-16.3). Declines in FACT-G (MD 4.3, 95% CI -1.0 to 9.6) and HCS (MD 4.3, 95% CI 0.8-7.9) scores appeared to contribute equally in both operative approaches to the decline in total FACT-Hep score. Patients who underwent robotic versus open operations both statistically and clinically significantly improved due to improvements in HCS (MD 6.1, 95% CI 2.3-9.9) but not in FACT-G (MD 1.2, 95% CI - 5.1-7.4). Conclusion: The robotic approach to pancreas surgery might offer, from the patient's perspective, greater improvement in symptoms over the open approach by three months postoperatively. (Copyright © 2022 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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