Robotic versus laparoscopic versus open surgery in morbidly obese endometrial cancer patients — A comparative analysis of total charges and complication rates
| Autor: | Kevin Blansit, John K. Chan, Daniel S. Kapp, Katie Taylor, Caroline A. Thompson, Xinhua Yu, A.B. Gardner |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Laparoscopic surgery medicine.medical_specialty medicine.medical_treatment Hysterectomy Young Adult Postoperative Complications Robotic Surgical Procedures medicine Humans Surgical Wound Infection Blood Transfusion Robotic surgery Lymphedema Urinary Tract Laparoscopy Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Endometrial cancer Obstetrics and Gynecology Postoperative complication Length of Stay Middle Aged medicine.disease Hospital Charges Respiration Artificial Endometrial Neoplasms Obesity Morbid Surgery Gastrointestinal Tract Oncology Female Complication business |
| Zdroj: | Gynecologic Oncology. 139:300-305 |
| ISSN: | 0090-8258 |
| Popis: | To compare the complications and charges of robotic vs. laparoscopic vs. open surgeries in morbidly obese patients treated for endometrial cancer.Data were obtained from the Nationwide Inpatient Sample from 2011. Chi-squared, Wilcoxon rank sum two-sample tests, and multivariate analyses were used for statistical analyses.Of 1087 morbidly obese (BMI ≥40kg/m(2)) endometrial cancer patients (median age: 59years, range: 22 to 89), 567 (52%) had open surgery (OS), 98 (9%) laparoscopic (LS), and 422 (39%) robotic surgery (RS). 23% of OS, 13% of LS, and 8% of RS patients experienced an intraoperative or postoperative complication including: blood transfusions, mechanical ventilation, urinary tract injury, gastrointestinal injury, wound debridement, infection, venous thromboembolism, and lymphedema (p0.0001). RS and LS patients were less likely to receive blood transfusions compared to OS (5% and 6% vs. 14%, respectively; p0.0001). The median lengths of hospitalization for OS, LS, and RS patients were 4, 1, and 1days, respectively (p0.0001). Median total charges associated with OS, LS, and RS were $39,281, $40,997, and $45,030 (p=0.037), respectively.In morbidly obese endometrial cancer patients, minimally invasive robotic or laparoscopic surgeries were associated with fewer complications and less days of hospitalization relative to open surgery. Compared to laparoscopic approach, robotic surgeries had comparable rates of complications but higher charges. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect