University of Portsmouth, School of Health and Care Professions, St Andrews Court, St Michael's road, Portsmouth, PO1 2PR, UK.
Champalimaud Foundation, Av. Brasilia, 1400-038, Lisbon, Portugal.
Langenbecks Arch Surg. 2023 May 4;408(1):175. doi: 10.1007/s00423-023-02898-1.
Laparoscopic ileal pouch-anal anastomosis (IPAA) surgery offers improved short-term outcomes over open surgery but can be technically challenging. Robotic surgery has been increasingly used for IPAA surgery, but there is limited evidence supporting its use. This study aims to compare the short-term outcomes of laparoscopic and robotic IPAA procedures.
All consecutive patients receiving laparoscopic and robotic IPAA surgery at 3 centres, from 3 countries, between 2008 and 2019 were identified from prospectively collated databases. Robotic surgery patients were propensity score matched with laparoscopic patients for gender, previous abdominal surgery, ASA grade (I, II vs III, IV) and procedure performed (proctocolectomy vs completion proctectomy). Their short-term outcomes were examined.
A total of 89 patients were identified (73 laparoscopic, 16 robotic). The 16 patients that received robotic surgery were matched with 15 laparoscopic patients. Baseline characteristics were similar between the two groups. There were no statistically significant differences in any of the investigated short-term outcomes. Length of stay trend was higher for laparoscopic surgery (9 vs 7 days, p = 0.072) CONCLUSION: Robotic IPAA surgery is safe and feasible and offers similar short-term outcomes to laparoscopic surgery. Length of stay may be lower for robotic IPAA surgery, but further larger scale studies are required in order to demonstrate this.
腹腔镜回肠贮袋肛管吻合术(IPAA)比开放手术具有更好的短期效果,但手术技术具有挑战性。机器人手术已越来越多地用于 IPAA 手术,但支持其使用的证据有限。本研究旨在比较腹腔镜和机器人 IPAA 手术的短期效果。
从 2008 年至 2019 年,从 3 个国家的 3 个中心前瞻性收集的数据库中确定了所有接受腹腔镜和机器人 IPAA 手术的连续患者。对机器人手术患者进行倾向评分匹配,与腹腔镜患者进行性别、既往腹部手术、ASA 分级(I、II 级与 III、IV 级)和手术方式(结肠切除术与完成性直肠切除术)匹配。检查了他们的短期结果。
共确定了 89 例患者(73 例腹腔镜,16 例机器人)。接受机器人手术的 16 例患者与 15 例腹腔镜患者进行了匹配。两组的基线特征相似。任何调查的短期结果均无统计学差异。腹腔镜手术的住院时间趋势较高(9 天与 7 天,p=0.072)。
机器人 IPAA 手术安全可行,短期效果与腹腔镜手术相似。机器人 IPAA 手术的住院时间可能较低,但需要进一步的大规模研究来证明这一点。