Combined robotic approach and enhanced recovery after surgery pathway for optimization of costs in patients undergoing proctectomy

Autor: N. Bouazza, H. Mathieu Daudé, A. Laine, Philippe Rouanet, M. Jarlier, A. Mermoud
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: BJS Open, Vol 4, Iss 3, Pp 516-523 (2020)
BJS Open
ISSN: 2474-9842
Popis: Background Enhanced recovery after surgery (ERAS) pathways are beneficial in proctocolectomy, but their impact on robotic low rectal proctectomy is not fully investigated. This study assessed the impact of an ERAS pathway on the outcomes and cost of robotic (RTME) versus laparoscopic (LTME) total mesorectal excision. Methods A retrospective review was performed of patients with rectal cancer in a single French tertiary centre for three yearly periods: 2011, LTME; 2015, RTME; and 2018, RTME with ERAS. Patient characteristics, operative and postoperative data, and costs were compared among the groups. Results A total of 220 consecutive proctectomies were analysed (71 LTME, 58 RTME and 91 RTME with ERAS). A prevalence of lower and locally advanced tumours was observed with RTME. The median duration of surgery increased with the introduction of RTME, but became shorter than that for LTME with greater robotic experience (226, 233 and 180 min for 2011, 2015 and 2018 respectively; P
Managing robotic total mesorectal excision (RTME) using an enhanced recovery after surgery (ERAS) programme in patients with rectal cancer decreased overall costs compared with RTME alone. The combination significantly decreased operating time, duration of hospital stay and global morbidity compared with RTME and laparoscopic total mesorectal excision alone. ERAS and robotic proctectomy for rectal cancer
Databáze: OpenAIRE
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