Short-term Outcome of Robot-assisted and Open IPAA:An Observational Single-center Study
| Autor: | Frederik Rønne Pachler, Peter Uhd Jepsen, Anders Mark-Christensen, Charlotte Buchard Nørager, Anders P. Tøttrup, Søren Laurberg |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Single Center law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans Laparoscopy Retrospective Studies Laparotomy medicine.diagnostic_test Proctocolectomy business.industry Proctocolectomy Restorative Gastroenterology Retrospective cohort study General Medicine Robotics medicine.disease Ulcerative colitis Colorectal surgery Surgery Treatment Outcome 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Observational study Colitis Ulcerative Female business Follow-Up Studies |
| Zdroj: | Mark-Christensen, A, Pachler, F R, Nørager, C B, Jepsen, P, Laurberg, S & Tøttrup, A 2016, ' Short-term Outcome of Robot-assisted and Open IPAA : An Observational Single-center Study ', Diseases of the Colon and Rectum, vol. 59, no. 3, pp. 201-7 . https://doi.org/10.1097/DCR.0000000000000540 |
| DOI: | 10.1097/DCR.0000000000000540 |
| Popis: | BACKGROUND: The potential advantages of robot-assisted laparoscopy are being increasingly investigated, although data on its efficacy in benign colorectal surgery are scarce.OBJECTIVE: We compared the early postoperative outcome in robot-assisted IPAA with open surgery procedures.DESIGN: This was an observational study based on prospectively collected data obtained from chart reviews.SETTING: The single-center data set covers patients operated on from January 13, 2004, to September 16, 2014, at a specialist center.PATIENTS: Patients with ulcerative colitis undergoing IPAA surgery were included.MAIN OUTCOME MEASURES: Study end points included the duration of operation, admission length, complications (Clavien-Dindo), reoperations, and readmissions.RESULTS: Eighty-one robot-assisted and 170 open IPAA procedures were performed. The duration of operation was significantly longer for robot-assisted laparoscopic procedures (mean difference, 154 minutes; CI, 140-170). During a mean follow-up of 102 days, no significant differences in the distribution of complications were found (Spearman p = 0.12; p = 0.07), and no postoperative deaths occurred in either group. Postoperative admission length was shorter following robot-assisted procedures (mean difference, -1.9; CI, -3.5 to -0.3), whereas 40% of patients were readmitted, compared with 26% of patients who had open surgery (OR, 1.9; CI, 1.1-3.4). Pouch failure occurred in 3 patients (1 following robot-assisted laparoscopy; 2 following open surgery). On multivariate regression analyses, robot-assisted laparoscopy was associated with a significantly longer duration of operation (mean difference, 159 minutes; CI, 144-174), and more readmissions for any cause (OR, 2; CI, 1.1-3.7).LIMITATIONS: This was a nonrandomized, single-center observational study.CONCLUSION: In this implementation phase, robot-assisted IPAA surgery offers acceptable short-term outcomes. The limitations of this observational study call for randomized controlled trials with long-term follow-up and exploration of functional results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|