Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA.
J Robot Surg. 2021 Jun;15(3):473-481. doi: 10.1007/s11701-020-01130-2. Epub 2020 Jul 28.
The literature surrounding emergent robotic ventral hernia repair (RVHR) is scarce. We aimed to present the results of 6 years of experience of RVHR in the emergency setting. Data were retrospectively analyzed from patients who underwent RVHR in an emergent setting between 2013 and 2019. Complications were assessed with the Clavien-Dindo (CD) and Comprehensive Complication Index (CCI) scoring systems. Kaplan-Meier's time-to-event analysis was performed to calculate freedom-of-recurrence. Out of 589 patients who underwent RVHR, 34 patients were included. Median APACHE-II scores were 6.5. The average skin-to-skin time was 139 min. 7/34(20.5%) patients experienced minor complications (CD-grades I-II) and 4/34 (11.7%) patients experienced major complications (CD-grades III-IV). CCI scores ranged from 0-42.4. Only one (2.9%) patient experienced hernia recurrence. The mean postoperative follow-up was 20.5 (range 1.6-56.3) months. Emergent RVHR showed promising results in terms of midterm outcomes and overall feasibility. RVHR appears to be effective in emergency settings, however, further multicenter studies with long-term follow-up are needed.
机器人紧急腹外疝修补术（RVHR）的相关文献较少。我们旨在报告 6 年来在急诊环境下进行 RVHR 的经验结果。对 2013 年至 2019 年在急诊环境下接受 RVHR 的患者进行回顾性数据分析。采用 Clavien-Dindo（CD）和综合并发症指数（CCI）评分系统评估并发症。采用 Kaplan-Meier 时间事件分析计算复发率。在 589 例行 RVHR 的患者中，纳入 34 例患者。平均急性生理与慢性健康评分（APACHE-II）为 6.5。平均皮肤到皮肤时间为 139 分钟。7/34（20.5%）例患者出现轻微并发症（CD 分级 I-II），4/34（11.7%）例患者出现严重并发症（CD 分级 III-IV）。CCI 评分范围为 0-42.4。仅有 1 例（2.9%）患者出现疝复发。平均术后随访时间为 20.5 个月（范围 1.6-56.3）。紧急 RVHR 在中期结果和整体可行性方面显示出良好的效果。RVHR 在急诊环境中似乎是有效的，但需要进一步进行长期随访的多中心研究。
