Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Via Massarenti, 9, 40138, Bologna, Italy.
Int J Colorectal Dis. 2024 Oct 10;39(1):158. doi: 10.1007/s00384-024-04736-2.
The aim of the study was to compare the perioperative outcomes of patients affected by inflammatory bowel disease (IBD) who underwent surgery performed through laparoscopy or using the Medtronic Hugo™ RAS.
This is a retrospective study from a prospectively maintained database comparing laparoscopic vs. robotic-assisted surgery for IBD from 01/11/2017 to 15/04/2024. All procedures were performed by a single surgeon robotic-naïve with a large experience in laparoscopic surgery for IBD. The robotic procedures were performed using the Medtronic Hugo™ RAS platform. Outcomes were 30-day postoperative complications, operative time, conversion rate, intraoperative complications, length of hospital stay, and readmission rate.
Among 121 consecutive patients, 80 underwent laparoscopic (LG) and 41 robotic-assisted surgery (RG). Baseline, preoperative and disease-specific characteristics were comparable except for older age (50 [38-56] vs. 38 [28-54] years; p = 0.05) and higher albumin level (42 [40-44] vs. 40 [38-42] g/L, p = 0.006) in the RG. The intracorporeal anastomosis was more frequent in the RG (80% vs. 6%; p < 0.001) with longer operative time (240 vs. 205 min; p = 0.006), while the conversion rate was not different (5% vs. 10%, p = 0.49). Surgical procedure types were equally distributed between the two groups, and the rate of intra-abdominal septic complication (IASC) was comparable across the different procedures. Postoperative complications were similar, including the rate of IASC (5% vs. 5%, p = 1), postoperative ileus (5% vs. 7.5%, p = 0.71), bleeding (2% vs. 5%, p = 0.66), and Clavien-Dindo > 2 complications (7% vs. 6%; p = 1).
IBD surgery performed using the Medtronic Hugo™ RAS is safe and feasible, with similar postoperative outcomes when compared to the laparoscopic approach.
本研究旨在比较接受腹腔镜或 Medtronic Hugo™ RAS 机器人辅助手术治疗炎症性肠病 (IBD) 患者的围手术期结局。
这是一项回顾性研究，从 2017 年 11 月 1 日至 2024 年 4 月 15 日，比较了腹腔镜与机器人辅助手术治疗 IBD 的前瞻性数据库。所有手术均由一位对 IBD 腹腔镜手术有丰富经验但对机器人手术不熟悉的外科医生完成。机器人手术使用 Medtronic Hugo™ RAS 平台进行。结果为 30 天术后并发症、手术时间、转化率、术中并发症、住院时间和再入院率。
在 121 例连续患者中，80 例接受腹腔镜（LG）手术，41 例接受机器人辅助手术（RG）。除了年龄较大（50[38-56] vs. 38[28-54]岁；p=0.05）和白蛋白水平较高（42[40-44] vs. 40[38-42]g/L，p=0.006）外，两组的基线、术前和疾病特异性特征均相似。RG 组更频繁地进行了腔内吻合术（80% vs. 6%；p<0.001），手术时间更长（240 分钟 vs. 205 分钟；p=0.006），但转化率无差异（5% vs. 10%，p=0.49）。两组的手术类型分布均匀，不同手术的腹腔内感染并发症（IASC）发生率相似。术后并发症相似，包括 IASC 发生率（5% vs. 5%，p=1）、术后肠梗阻（5% vs. 7.5%，p=0.71）、出血（2% vs. 5%，p=0.66）和 Clavien-Dindo>2 级并发症（7% vs. 6%；p=1）。
使用 Medtronic Hugo™ RAS 进行 IBD 手术是安全可行的，与腹腔镜方法相比，术后结果相似。
