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头颈部经口机器人手术中的不良事件报告:MAUDE 数据库研究。

Adverse event reporting in head and neck transoral robotic surgery: a MAUDE database study.

机构信息

Department of Surgery, Sanford Ear, Nose, and Throat Clinic, University of South Dakota Sanford School of Medicine, 1310 W 22nd St., Sioux Falls, SD, 57105, USA.

出版信息

J Robot Surg. 2021 Dec;15(6):899-904. doi: 10.1007/s11701-020-01185-1. Epub 2021 Jan 23.

Abstract

Transoral robotic surgery (TORS) using the da Vinci Surgical system was approved by the US Food and Drug Administration in 2009. Currently, most available safety information on TORS procedures describes adverse events occurring in the context of clinical trials or series at high-volume academic centers. The goal of this study was to catalog reported adverse events associated with the da Vinci device in head and neck procedures by querying an FDA database. A search was performed on the MAUDE database inspecting for TORS safety incident reports generated from January 2009 through May 2020 using key words "da Vinci" and "Intuitive Surgical". A total of 3312 medical device records were produced. Of these 36 head and neck adverse events, reports were identified through manual screening of the data by the authors. Death was found to be the most common adverse event reported overall, manifesting in 44% of all reported incidents. The most frequent source of mortality was found to be hemorrhaging in the perioperative period rather than incidents of device malfunction or structural damage from surgery. This was found to be similar to the results of other published series for transoral ablative surgery. This study suggests that the small number of reported adverse events related to TORS with the da Vinci system seems to mirror what would be expected from the same procedures using other methods for transoral surgery.

摘要

经美国食品和药物管理局批准,2009 年开始使用达芬奇手术系统进行经口机器人手术(TORS)。目前,大多数关于 TORS 手术的可用安全性信息都是在临床试验或高容量学术中心的系列研究中描述不良事件。本研究的目的是通过查询 FDA 数据库,对达芬奇设备在头颈部手术中报告的不良事件进行编目。使用关键词“达芬奇”和“直觉外科”在 MAUDE 数据库中进行搜索,检索了 2009 年 1 月至 2020 年 5 月期间生成的 TORS 安全事件报告。共产生了 3312 份医疗器械记录。通过作者对数据的手动筛选,确定了其中 36 例头颈部不良事件报告。结果发现,死亡是所有报告事件中最常见的不良事件,占所有报告事件的 44%。最常见的死亡原因是围手术期出血,而不是设备故障或手术导致的结构损伤。这与其他发表的经口消融手术系列结果相似。本研究表明,达芬奇系统 TORS 报告的不良事件数量较少,这似乎与使用其他经口手术方法的相同手术的预期结果相符。

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