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全机器人胃旁路手术后的围手术期结果:一项前瞻性非随机对照研究。

Perioperative outcomes after totally robotic gastric bypass: a prospective nonrandomized controlled study.

机构信息

Multidisciplinary Unit for Obesity Surgery UMCO, Centre Hospitalier Universitaire de Nancy, 54511 Vandoeuvre, France.

出版信息

Am J Surg. 2013 Aug;206(2):145-51. doi: 10.1016/j.amjsurg.2012.07.049. Epub 2013 Jun 2.

DOI:10.1016/j.amjsurg.2012.07.049
PMID:23735669
Abstract

BACKGROUND

Perioperative short-term outcomes could be improved after totally robotic Roux-en-Y gastric bypass (TR-RYGBP) compared with conventional laparoscopic gastric bypass.

METHODS

This is a nonrandomized controlled prospective study (N = 200) to evaluate perioperative short-term outcomes. The primary endpoint was to investigate risk factors for 30-day surgical complications.

RESULTS

Mean total operative time was shorter in patients who underwent TR-RYGBP (130 vs 147 minutes; P < .0001). However, postoperative surgical complications rate (13% vs 1%; P = .001), and mean overall hospital stay (9.3 vs 6.7 days; P < .0001) were higher after TR-RYGBP. By multivariate analysis, robotic surgery (hazard ratio [HR] = 15.1; 95% confidence interval [CI], 2.8 to 280; P = .01), and conversion to laparotomy (HR = 18.8; 95% CI, 1.7 to 250.8; P = .014) were independent risk factors for 30-day surgical complications.

CONCLUSIONS

Although robotic gastric bypass reduces mean operative time, TR-RYGBP is associated with an increased postoperative surgical complications rate and longer hospitalization.

摘要

背景

与传统腹腔镜胃旁路手术相比,全机器人 Roux-en-Y 胃旁路术(TR-RYGBP)可改善围手术期短期结局。

方法

这是一项非随机对照前瞻性研究(N=200),旨在评估围手术期短期结局。主要终点是调查 30 天手术并发症的危险因素。

结果

TR-RYGBP 组的平均总手术时间更短(130 分钟比 147 分钟;P<0.0001)。然而,TR-RYGBP 组术后手术并发症发生率(13%比 1%;P=0.001)和平均总住院时间(9.3 天比 6.7 天;P<0.0001)更高。多因素分析显示,机器人手术(风险比[HR]=15.1;95%置信区间[CI],2.8 至 280;P=0.01)和中转开腹(HR=18.8;95%CI,1.7 至 250.8;P=0.014)是 30 天手术并发症的独立危险因素。

结论

虽然机器人胃旁路术可缩短平均手术时间,但 TR-RYGBP 与术后手术并发症发生率增加和住院时间延长有关。

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