Section of Minimally Invasive, Robotic and Bariatric Surgery, Department of Surgery, University of Arizona College of Medicine, 1501N, Campbell Avenue, P.O. Box 245066, Tucson, AZ, 85724-5066, USA.
Epidemiology and Biostatistics Department, University of Arizona College of Public Health, Tucson, AZ, USA.
Obes Surg. 2023 Sep;33(9):2671-2678. doi: 10.1007/s11695-023-06720-1. Epub 2023 Jul 11.
Utilization of the robotic platform in bariatric surgery has increased over the past several years. The population of older adults who benefit from bariatric surgery is also growing. This study evaluated the safety of robotic-assisted bariatric surgery in older adults using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Database.
Adults who underwent gastric bypass or sleeve gastrectomy and were ≥ 65 years old between the years 2015 and 2021 were included. The 30-day outcomes were assessed and stratified based on Clavien-Dindo (CD) classification of III-V. Univariable and multivariable logistic regressions were performed to identify predictors of CD ≥ III complications.
A total of 62,973 bariatric surgery patients were included. Most of the patients (90%) underwent laparoscopic surgery, and the remainder (10%) underwent robotic surgery. Robotic sleeve gastrectomy (R-SG) was associated with lower odds of developing CD ≥ III complications compared to three other procedures (adjusted odds ratio (aOR), 0.741; confidence interval (CI), 0.584-0.941; p 0.014).
Bariatric surgery using a robotic approach is considered safe for older patients. Robotic sleeve gastrectomy (R-SG) has the lowest morbidity and mortality rates compared to laparoscopic sleeve gastrectomy (L-SG), laparoscopic Roux-en-Y gastric bypass (L-RYGB), and robotic Roux-en-Y gastric bypass (R-RYGB). The findings of this study can help surgeons and their elderly patients to make informed decisions regarding the safety of different bariatric surgical approaches.
在过去几年中，机器人平台在减重手术中的应用有所增加。受益于减重手术的老年人群体也在增加。本研究使用代谢和减重外科认证和质量改进计划（MBSAQIP）数据库评估了机器人辅助减重手术在老年人中的安全性。
纳入 2015 年至 2021 年间年龄≥65 岁接受胃旁路或袖状胃切除术的成年人。评估 30 天的结果，并根据 Clavien-Dindo（CD）分类 III-V 进行分层。进行单变量和多变量逻辑回归分析，以确定 CD≥III 并发症的预测因素。
共纳入 62973 例减重手术患者。大多数患者（90%）接受腹腔镜手术，其余（10%）接受机器人手术。与其他三种手术相比，机器人袖状胃切除术（R-SG）发生 CD≥III 并发症的几率较低（调整后的优势比（aOR），0.741；置信区间（CI），0.584-0.941；p=0.014）。
对于老年患者，使用机器人方法进行减重手术被认为是安全的。与腹腔镜袖状胃切除术（L-SG）、腹腔镜 Roux-en-Y 胃旁路术（L-RYGB）和机器人 Roux-en-Y 胃旁路术（R-RYGB）相比，机器人袖状胃切除术（R-SG）的发病率和死亡率最低。本研究的结果可以帮助外科医生及其老年患者就不同减重手术方法的安全性做出明智的决策。
