Pepper Victoria K, Rager Terrence M, Diefenbach Karen A, Raval Mehul V, Teich Steven, Michalsky Marc P
Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, WB4154, Columbus, OH, 43212, USA.
Department of Surgery, OSU Medical Center, Columbus, OH, USA.
Obes Surg. 2016 Aug;26(8):1912-7. doi: 10.1007/s11695-015-2029-4.
The rising prevalence of childhood obesity and concomitant increase in comorbid disease pose significant challenges for the health care system. While mounting evidence demonstrates the safety and efficacy of bariatric surgery for severely obese adolescents, the potential role of robotic technology has not been well defined.
The aim of this study was to establish the safety and efficacy of robotic-assisted laparoscopic sleeve gastrectomy (RSG) in treating severe adolescent obesity. In addition, 30-day outcomes and hospital charges were compared to subjects undergoing RSG versus laparoscopic sleeve gastrectomy (LSG).
A retrospective analysis of 28 subjects (14 LSG vs. 14 RSG) at a single institution was conducted. Data collection included demographics, body mass index, comorbidities, hospital length of stay (LOS), operative time, 30-day outcomes, and hospital charges. Analysis was performed using chi-square, Fisher's exact, and nonparametric Wilcoxon rank sum tests.
There were no differences in subject demographics or comorbidities. While median operative time was longer for RSG vs. LSG (132 vs. 100 min, p = 0.0002), the median LOS for RSG compared to LSG was shorter (69.6 vs. 75.9 h, p = 0.0094). In addition, RSG-related hospital charges were higher ($56,646 vs. $49,498, p = 0.0366). No significant differences in post-operative outcomes or complications were observed.
RSG is equally safe and efficacious when compared to LSG among adolescents. Similar to studies in adults, LOS is shortened while hospital charges are higher. Larger prospective studies are needed to gain insight regarding cost benefit ratios.
儿童肥胖患病率的上升以及随之而来的合并症增加，给医疗保健系统带来了重大挑战。虽然越来越多的证据表明减重手术对重度肥胖青少年具有安全性和有效性，但机器人技术的潜在作用尚未得到明确界定。
本研究的目的是确定机器人辅助腹腔镜袖状胃切除术（RSG）治疗重度青少年肥胖的安全性和有效性。此外，还比较了接受RSG与腹腔镜袖状胃切除术（LSG）的患者的30天结局和住院费用。
对一家机构的28名受试者（14例LSG vs. 14例RSG）进行回顾性分析。数据收集包括人口统计学、体重指数、合并症、住院时间（LOS）、手术时间、30天结局和住院费用。使用卡方检验、Fisher精确检验和非参数Wilcoxon秩和检验进行分析。
受试者的人口统计学或合并症无差异。虽然RSG的中位手术时间比LSG长（132 vs. 100分钟，p = 0.0002），但RSG的中位LOS比LSG短（69.6 vs. 75.9小时，p = 0.0094）。此外，与RSG相关的住院费用更高（56,646美元vs. 49,498美元，p = 0.0366）。术后结局或并发症未观察到显著差异。
在青少年中，RSG与LSG相比同样安全有效。与成人研究相似，住院时间缩短，但住院费用更高。需要进行更大规模的前瞻性研究来深入了解成本效益比。
