A retrospective comparison of 90-day outcomes, length of stay, and readmissions between robotic-assisted and laparoscopic colectomy.

Autor: Pervaiz SS; Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA., D'Adamo C; Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Mavanur A; Department of Surgery, Sinai Hospital, Baltimore, MD, USA.; Department of Surgery, Georgetown University, Washington, DC, USA.; Department of Surgery, Johns Hopkins University, Baltimore, MD, USA., Wolf JH; Department of Surgery, Sinai Hospital, Baltimore, MD, USA. Joswolf@lifebridgehealth.org.; Department of Surgery, Georgetown University, Washington, DC, USA. Joswolf@lifebridgehealth.org.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2023 Oct; Vol. 17 (5), pp. 2205-2209. Date of Electronic Publication: 2023 Jun 05.
DOI: 10.1007/s11701-023-01642-7
Abstrakt: Investigations generally assess 30 days of perioperative outcomes with robotic-assisted and laparoscopic colectomy. Outcomes beyond 30 days serve as a quality metric of surgical services and an assessment of 90 days of outcomes may have greater clinical utility. The purpose of this study was to assess 90 days of outcomes, length of stay (LOS), and readmissions among patients who underwent a robotic-assisted versus laparoscopic colectomy using a national database. Patients undergoing either robotic-assisted or laparoscopic colectomy were identified using Current Procedural Terminology (CPT) codes within PearlDiver, a national, inpatient records database from 2010 to 2019. Outcomes were defined using the National Surgical Quality Improvement Program (NSQIP) risk calculator and identified using International Classification of Disease (ICD) diagnosis codes. Categorical variables were compared using chi-square tests, and continuous variables were compared using paired t tests. Covariate-adjusted regression models were also constructed to evaluate these associations while accounting for potential confounders. A total of 82,495 patients were assessed in this study. At 90 days, patients of the laparoscopic colectomy cohort experienced a higher rate of complications than patients who underwent robotic-assisted colectomy (9.5 vs. 6.6%, p < 0.001). There were no significant differences in LOS (6 vs. 6.5 days, p = 0.08) and readmissions (6.1 vs. 6.7%, p = 0.851) at 90 days. Patients undergoing robotic-assisted colectomy have a lower risk for morbidity at 90 days. Neither approach is superior for LOS nor 90 days of readmissions. Both techniques are effective minimally invasive procedures, yet patients may gain a greater risk benefit from robotic colectomy.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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