A population-based study comparing laparoscopic and robotic outcomes in colorectal surgery

Autor: Michael S. Tam, Samantha Hendren, Andrew J. Mullard, Robert K. Cleary, Richard M. Lampman, James F. Vandewarker, Scott E. Regenbogen, Michael G. Franz, Greta L. Krapohl, Christodoulos Kaoutzanis
Rok vydání: 2015
Předmět:
Zdroj: Surgical Endoscopy. 30:455-463
ISSN: 1432-2218
0930-2794
DOI: 10.1007/s00464-015-4218-6
Popis: Current data addressing the role of robotic surgery for the management of colorectal disease are primarily from single-institution and case-matched comparative studies as well as administrative database analyses. The purpose of this study was to compare minimally invasive surgery outcomes using a large regional protocol-driven database devoted to surgical quality, improvement in patient outcomes, and cost-effectiveness. This is a retrospective cohort study from the prospectively collected Michigan Surgical Quality Collaborative registry designed to compare outcomes of patients who underwent elective laparoscopic, hand-assisted laparoscopic, and robotic colon and rectal operations between July 1, 2012 and October 7, 2014. We adjusted for differences in baseline covariates between cases with different surgical approaches using propensity score quintiles modeled on patient demographics, general health factors, diagnosis, and preoperative co-morbidities. The primary outcomes were conversion rates and hospital length of stay. Secondary outcomes included operative time, and postoperative morbidity and mortality. A total of 2735 minimally invasive colorectal operations met inclusion criteria. Conversion rates were lower with robotic as compared to laparoscopic operations, and this was statistically significant for rectal resections (colon 9.0 vs. 16.9 %, p
Databáze: OpenAIRE
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