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。