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机器人辅助手术治疗复杂和非复杂憩室炎:单外科医生病例系列比较。

Robotic-assisted surgery for complicated and uncomplicated diverticulitis: A single-surgeon case-series comparison.

机构信息

Department of Colorectal Surgery, George Washington University Hospital, Washington, District of Columbia, USA.

Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

出版信息

Int J Med Robot. 2021 Aug;17(4):e2271. doi: 10.1002/rcs.2271. Epub 2021 May 11.

Abstract

BACKGROUND

Robotic-assisted techniques in colorectal surgery have dramatically increased. Comparative data on the management of uncomplicated and complicated diverticulitis using robotics is lacking. The purpose of this study is to examine outcomes of patients who underwent robotic-assisted resection in diverticulitis.

METHODS

A prospectively maintained database performed by a single surgeon was retrospectively reviewed to identify patients who underwent robotic-assisted surgery (RAS) for diverticulitis from October 2009 to November 2018. Demographic data, preoperative and intraoperative parameters and postoperative outcomes were assessed using χ or Fisher exact test with p values <0.05 considered significant. IRB approval was obtained for this study, #NCR190935.

RESULTS

Comparison revealed significant differences in operative times (222 vs. 291 min, p < 0.00001), mean estimated blood loss (130 vs. 304 cc, p = 0.0003) and mean length of stay (3.9 vs. 5.0 days, p = 0.006). Low rates of postoperative complications were observed, with no significant differences noted for conversion to laparoscopy, surgical site infection, leak, intra-abdominal abscess, 30-day unplanned readmission or recurrence.

CONCLUSION

Patients with complicated diverticulitis required longer operative time, had increased estimated blood loss and more often converted to an open procedure; however, overall rates of post-operative complications were low in both groups. RAS shows promise for use in complicated diverticulitis.

摘要

背景

结直肠手术中的机器人辅助技术有了显著的提高。关于使用机器人治疗单纯性和复杂性憩室炎的比较数据尚缺乏。本研究的目的是研究接受机器人辅助憩室炎切除术患者的结局。

方法

回顾性分析一位外科医生进行的前瞻性维护数据库,以确定 2009 年 10 月至 2018 年 11 月期间接受机器人辅助手术(RAS)治疗憩室炎的患者。使用 χ 或 Fisher 确切检验评估人口统计学数据、术前和术中参数以及术后结果,p 值<0.05 认为有统计学意义。本研究获得了 IRB 批准,#NCR190935。

结果

比较发现手术时间(222 分钟与 291 分钟,p<0.00001)、平均估计出血量(130 毫升与 304 毫升,p=0.0003)和平均住院时间(3.9 天与 5.0 天,p=0.006)有显著差异。术后并发症发生率较低,两组之间无统计学差异的指标包括转为腹腔镜手术、手术部位感染、漏、腹腔脓肿、30 天非计划性再入院或复发。

结论

复杂性憩室炎患者需要更长的手术时间、更多的估计出血量,且更常转为开放性手术;但两组患者的术后并发症发生率均较低。RAS 在复杂性憩室炎中具有应用前景。

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