How does robotic anti-reflux surgery compare with traditional open and laparoscopic techniques: a cost and outcomes analysis

Autor: Dmitry Oleynikov, Benjamin D. Owen, Andy B. Siref, Valerie Shostrom, Anton Simorov
Rok vydání: 2014
Předmět:
Zdroj: Surgical Endoscopy. 28:1686-1690
ISSN: 1432-2218
0930-2794
DOI: 10.1007/s00464-013-3372-y
Popis: Conventional laparoscopic fundoplications (CLF) have been the gold standard for Nissen fundoplications (NFs) for two decades. The advent of a robotic approach for fundoplication procedures creates a potential alternative. Thus, we used a national database to examine perioperative outcomes with respect to open, laparoscopic, and robotic approaches. The University Health System Consortium is an alliance of medical centers, numbering over 115 academic institutions and their 271 affiliated hospitals. We used International Classification of Diseases codes to elicit patients over the age of 18 years who received NF procedures. A total of 12,079 patients of similar demographic background received fundoplication procedures from October 2008 to June 2012. Of those, 2,168 were open fundoplications (OF), 9,572 were CLF, and 339 were robot-assisted laparoscopic fundoplications (RLF). CLF and RLF displayed no significance in mortality (0.1 vs. 0 %; p = 0.5489), morbidity (4.0 vs. 5.6 %; p = 0.1744), length of stay (2.8 ± 3.6 vs. 3.0 ± 3.5; p = 0.3242), and intensive care unit (ICU) cases (8.4 vs. 11.5 %; p = 0.051). However, CLF remained superior, with a lower 30-day re-admission rate (1.8 vs. 3.6 %; p
Databáze: OpenAIRE
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