Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Surg Endosc. 2019 Dec;33(12):4171-4176. doi: 10.1007/s00464-019-06727-9. Epub 2019 Mar 13.
This study aimed to assess intra- and postoperative outcomes of robotic resection of left-sided complicated diverticular disease. Retrospective analysis of a prospectively maintained institutional database on consecutive patients undergoing elective robotic resection for diverticular disease (2014-2018). All procedures were performed within an enhanced recovery pathway (ERP). Demographic, surgical and ERP-related items were compared between patients with simple and complicated diverticular disease according to intra-operative presentation. Postoperative complications and length of stay were compared between the two groups. Out of 150 patients, 78 (52%) presented with complicated and the remaining 72 (48%) with uncomplicated disease. Both groups were comparable regarding demographic baseline characteristics and overall ERP compliance. Surgery for complicated disease was longer (288 ± 96 vs. 258 ± 72 min, p = 0.04) and more contaminated (≥ class 3: 57.7 vs. 23.6%, p < 0.001) with a trend to higher conversion rates (10.3 vs. 2.8%, p = 0.1). While postoperative overall complications tended to occur more often after resections for complicated disease (28.2 vs. 15.3%, p = 0.075), major, surgical and medical complications did not differ between the two groups, and median length of stay was 3 days in both settings (p = 0.19). Robotic resection of diverticular disease was feasible and safe regardless of disease presentation by the time of surgery.
本研究旨在评估机器人左半侧复杂憩室病切除术的围手术期结果。对 2014 年至 2018 年间连续接受择期机器人憩室病切除术的患者进行前瞻性维护的机构数据库进行回顾性分析。所有手术均在强化康复途径 (ERP) 内进行。根据术中表现，比较简单和复杂憩室病患者的人口统计学、手术和 ERP 相关项目。比较两组患者的术后并发症和住院时间。在 150 例患者中，78 例（52%）为复杂憩室病，72 例（48%）为单纯憩室病。两组患者的人口统计学基线特征和整体 ERP 依从性均相似。复杂疾病的手术时间更长（288 ± 96 分钟 vs. 258 ± 72 分钟，p = 0.04），污染程度更高（≥3 级：57.7% vs. 23.6%，p < 0.001），转化率也有升高趋势（10.3% vs. 2.8%，p = 0.1）。尽管术后总体并发症在复杂疾病手术后更常发生（28.2% vs. 15.3%，p = 0.075），但两组之间主要并发症、手术并发症和医疗并发症并无差异，且两种情况下的中位住院时间均为 3 天（p = 0.19）。无论手术时的疾病表现如何，机器人憩室病切除术都是可行且安全的。
