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Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study
Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study
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摘要：
BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically challenging.Robotic surgery has been introduced to overcome this technical limitation,but it is related to high costs.To maximize the benefits of such surgery,only selected patients are candidates for this technique.In addition,due to progressive aging of the population,an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities,who are usually more prone to post-operative complications.AIM To investigate the outcomes of RRH vs LRH with regard to age and comorbidities.METHODS We retrospectively analyzed 123 minimally invasive procedures(68 LRHs vs 55 RRHs)for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September 2019.The surgical procedures were performed according to standardized techniques.The primary clinical outcome of the study was the length of hospital stay(LOS)measured in days.Secondary outcomes were time to first flatus(TFF)and time to first stool evacuation.The robotic technique was considered the exposure and the laparoscopic technique was considered the control.Routine demographic variables were obtained,including age at time of surgery and gender.Body mass index and American Society of Anesthesiologists physical status were registered.The age-adjusted Charlson Comorbidity Index(ACCI)was calculated;the tumornode-metastasis system,intra-operative variables and post-operative complications were recorded.Post-operative follow-up was 180 d.RESULTS LOS,TFF,and time to first stool were significantly shorter in the robotic group:Median 6[interquartile range(IQR)5-8]vs 7(IQR 6-10.5)d,P=0.028;median 2(IQR 1-3)vs 3(IQR 2-4)d,P<0.001;median 4(IQR 3-5)vs 5(IQR 4-6.5)d,P=0.005,respectively.Following multivariable analysis,the robotic technique was confirmed to be predictive of significantly shorter hospitalization and fa
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| 篇名 | Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study | ||
| 来源期刊 | 世界胃肠外科杂志:英文版(电子版) | 学科 | 医学 |
| 关键词 | Right hemicolectomy Robotic surgery Laparoscopic surgery Elderly patients COMORBIDITY Hospital stay | ||
| 年，卷（期） | 2020,（6） | 所属期刊栏目 | |
| 研究方向 | 页码范围 | 287-297 | |
| 页数 | 11页 | 分类号 | R735.35 |
| 字数 | 语种 | ||
| DOI | |||
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Right
hemicolectomy
Robotic
surgery
Laparoscopic
surgery
Elderly
patients
COMORBIDITY
Hospital
stay
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世界胃肠外科杂志：英文版（电子版）
主办单位：
百世登出版集团有限公司
出版周期：
月刊
ISSN：
1948-9366
CN：
开本：
出版地：
北京市朝阳区东四环中路62号楼远洋国际中
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75
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