Comparison of 30-Day Postoperative Outcomes after Laparoscopic vs Robotic Colectomy
Autor: | Haisar Dao, Nivedh Paluvoi, Nishit Shah, David A. Margolin, H. Vargas, Matthew B. Bailey, Peter E. Miller |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Colectomies Databases Factual medicine.medical_treatment Operative Time 03 medical and health sciences Postoperative Complications 0302 clinical medicine Robotic Surgical Procedures Outcome Assessment Health Care medicine Humans Laparoscopy Colectomy Aged Retrospective Studies medicine.diagnostic_test business.industry technology industry and agriculture Retrospective cohort study Length of Stay Middle Aged Colorectal surgery Surgery body regions Logistic Models Elective Surgical Procedures 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Robotic colectomy Elective Surgical Procedure business human activities |
Zdroj: | Journal of the American College of Surgeons. 223:369-373 |
ISSN: | 1072-7515 |
Popis: | The robotic platform has been used increasingly to perform colorectal surgery. The benefits of robotic colectomy when compared with laparoscopic colectomy have not been definitively established.A retrospective review of the NSQIP database was performed on patients undergoing elective laparoscopic or robotic colectomy in 2013. Demographic characteristics, length of stay, operative time, and 30-day postoperative complications were compared between the 2 groups.Of the 17,774 colectomies performed during the study period, 11,267 (63.4%) were performed laparoscopically and 653 (3.7%) were performed robotically. In comparison with laparoscopic colectomy, robotic colectomy was associated with increased operative time (233 vs 180 minutes; p0.01) and decreased length of stay (5.04 vs 6.06 days; p 0.01). There was no significant difference with respect to mortality (0.2% vs 0.4%; p 0.312), anastomotic leak (3.4% vs 3.1%; p = 0.715), reoperation (4.9% vs 4.0%; p = 0.27), conversion (10.3% vs 12.2%; p = 0.13), or readmission (9.3% vs 8.7%; p = 0.593) rates. The differences in length of stay and operative time persisted in the right colectomy and left colectomy/sigmoid resection subgroup analysis with no difference in conversion rates.In this head-to-head comparison of laparoscopic colectomy and robotic colectomy, the majority of postoperative outcomes were equivalent, except for an increase in operative time and shorter length of stay in the robotic group. Robotic colectomy appears to be a safe option for minimally invasive colectomy, but additional studies are needed to elucidate whether it is cost-effective when compared with laparoscopic colectomy. |
Databáze: | OpenAIRE |
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