St. Luke's University Health Network (SLUHN), Bethlehem, PA, USA.
Temple Lewis Katz School of Medicine, Philadelphia, USA.
J Robot Surg. 2021 Apr;15(2):235-239. doi: 10.1007/s11701-020-01098-z. Epub 2020 May 30.
In recent years, there has been a significant increase in the number of Revisional Bariatric Surgery (RBS) cases performed to address complications and weight recidivism. The use of the da Vinci robotic platform, considered controversial by many, may offer advantages in RBS. The objective of our study is to compare the outcomes of Robotic RBS (R-RBS) to Laparoscopic RBS (L-RBS). Using the 2015-2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, we selected all RBS and we matched R-RBS to L-RBS using a propensity score matching system to create balanced groups. Our primary outcomes were 30-day Serious Adverse Events (SAE), 30-day Organ Specific Infection (OSI), 30-day reoperation and 30-day interventions. Our secondary outcomes included length of operation and 30-day readmission. We conducted separate Mann-Whitney rank sums tests or chi-square tests and Fisher exact test. R-RBS and L-RBS included 220 patients each. The overall incidence of 30-day SAEs, 30-day OSIs, 30-day reoperations, 30-day interventions were lower for R-RBS (6.4%, 0.9%, 2.7% and 2.3%, respectively) compared L-RBS (7.7%, 1.4%, 3.6% and 3.6%, respectively). Subgroup analysis showed that R-RBS had a lower rate of complications for the Gastric Bypass procedure but not for Sleeve gastrectomy cases. However, 30-day readmission was higher for R-RBS compared to L-RBS (9.1% vs 6.4% respectively). None of the analyses reached statistical significance. R-RBS took significantly longer compared to L-RBS (169 min vs 138 min, p < 0.05). Our study shows that R-RBS has lower complication rate albeit non-significant as compared to L-RBS.
近年来，由于需要处理并发症和体重反弹问题，翻修减重手术（RBS）的数量显著增加。使用达芬奇机器人平台，尽管有许多人对此持争议态度，但在 RBS 中可能具有优势。我们的研究目的是比较机器人 RBS（R-RBS）和腹腔镜 RBS（L-RBS）的结果。我们使用 2015-2017 年代谢和减重手术认证和质量改进计划（MBSAQIP）数据库，选择所有 RBS，并使用倾向评分匹配系统将 R-RBS 与 L-RBS 进行匹配，以创建平衡组。我们的主要结果是 30 天严重不良事件（SAE）、30 天器官特异性感染（OSI）、30 天再次手术和 30 天干预。我们的次要结果包括手术时间和 30 天再入院。我们进行了单独的曼-惠特尼秩和检验或卡方检验和 Fisher 精确检验。R-RBS 和 L-RBS 分别包括 220 例患者。R-RBS 的 30 天 SAE、30 天 OSI、30 天再次手术和 30 天干预的总体发生率较低（分别为 6.4%、0.9%、2.7%和 2.3%），而 L-RBS 则较高（分别为 7.7%、1.4%、3.6%和 3.6%）。亚组分析表明，R-RBS 胃旁路术的并发症发生率较低，但袖状胃切除术病例的并发症发生率则没有降低。然而，与 L-RBS 相比，R-RBS 的 30 天再入院率较高（分别为 9.1%和 6.4%）。这些分析均无统计学意义。与 L-RBS 相比，R-RBS 的手术时间明显延长（169 分钟对 138 分钟，p<0.05）。我们的研究表明，与 L-RBS 相比，R-RBS 的并发症发生率虽然没有统计学意义，但较低。
