Differences in Effectiveness and Use of Robotic Surgery in Patients Undergoing Minimally Invasive Colectomy.
J Gastrointest Surg
; 21(8): 1296-1303, 2017 08.
Article
em En
| MEDLINE
| ID: mdl-28567574
ABSTRACT
BACKGROUND:
We compared patient outcomes of robot-assisted surgery (RAS) and laparoscopic colectomy without robotic assistance for colon cancer or nonmalignant polyps, comparing all patients, obese versus nonobese patients, and male versus female patients.METHODS:
We used the 2013-2015 American College of Surgeons National Surgical Quality Improvement Program data to examine a composite outcome score comprised of mortality, readmission, reoperation, wound infection, bleeding transfusion, and prolonged postoperative ileus. We used propensity scores to assess potential heterogeneous treatment effects of RAS by patient obesity and sex.RESULTS:
In all, 17.1% of the 10,844 of patients received RAS. Males were slightly more likely to receive RAS. Obese patients were equally likely to receive RAS as nonobese patients. In comparison to nonRAS, RAS was associated with a 3.1% higher adverse composite outcome score. Mortality, reoperations, wound infections, sepsis, pulmonary embolisms, deep vein thrombosis, myocardial infarction, blood transfusions, and average length of hospitalization were similar in both groups. Conversion to open surgery was 10.1% lower in RAS versus nonRAS patients, but RAS patients were in the operating room an average of 52.4 min longer. We found no statistically significant differences (p > 0.05) by obesity status and gender.CONCLUSIONS:
Worse patient outcomes and no differential improvement by sex or obesity suggest more cautious adoption of RAS.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Padrões de Prática Médica
/
Pólipos do Colo
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Laparoscopia
/
Colectomia
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Neoplasias do Colo
/
Procedimentos Cirúrgicos Robóticos
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Gastrointest Surg
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos