Department of Surgery, Albany Medical Center, 43 New Scotland Avenue, Albany, NY, 12208, USA.
Albany Medical College, 43 New Scotland Avenue, Albany, NY, 12208, USA.
Surg Endosc. 2022 Feb;36(2):1573-1577. doi: 10.1007/s00464-021-08447-5. Epub 2021 Mar 24.
Perforated gastrojejunal ulcers are a known complication following Roux-en-Y gastric bypass (RYGB) surgery requiring emergent surgical repair. The robotic approach has not been evaluated for emergency general surgery.
A retrospective cohort study from 2015 to 2019 was performed identifying all patients who underwent repair of perforated gastrojejunal ulcers after RYGB at a single institution. Patient characteristics and outcomes were compared by robotic or laparoscopic approach.
Of the 44 patients analyzed, there were 24 robotic and 20 laparoscopic repairs of perforated gastrojejunal ulcers. No patients were initially approached with open surgery. In-room-to-surgery-start time was significantly faster in the robotic group than the laparoscopic group (25 versus 31 min, p = 0.01). Complication rate, complication severity, operating time, hospital length of stay, postoperative vasopressor requirement, discharge to home, hospital length of stay and 30-day readmission were all improved in the robotic group, although these were not statistically significant. Both total inpatient and procedural costs were more in the robotic group than the laparoscopic group.
Perforated hollow viscus is not a contraindication for the use of the surgical robot, which may improve outcomes.
胃旁路术后（RYGB）发生穿孔性胃肠溃疡是一种已知的并发症，需要紧急手术修复。机器人手术在急诊普通外科中尚未得到评估。
对 2015 年至 2019 年期间在一家机构接受 RYGB 后穿孔性胃肠溃疡修复的所有患者进行了回顾性队列研究。通过机器人或腹腔镜方法比较患者特征和结果。
在分析的 44 名患者中，有 24 名接受了机器人手术修复，20 名接受了腹腔镜手术修复。没有患者最初采用开放性手术。机器人组的手术开始时间明显快于腹腔镜组（25 分钟与 31 分钟，p=0.01）。机器人组的并发症发生率、并发症严重程度、手术时间、住院时间、术后血管加压素需求、出院回家、住院时间和 30 天再入院率均有所改善，尽管这些差异没有统计学意义。机器人组的总住院和手术费用均高于腹腔镜组。
穿孔性空腔脏器不是使用手术机器人的禁忌症，它可能改善结果。
