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使用美敦力 Hugo™ 机器人辅助手术平台进行机器人手术治疗炎症性肠病的结果:单中心经验。

Outcomes of robotic surgery for inflammatory bowel disease using the Medtronic Hugo™ Robotic-Assisted Surgical platform: a single center experience.

机构信息

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.

出版信息

Int J Colorectal Dis. 2024 Oct 10;39(1):158. doi: 10.1007/s00384-024-04736-2.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

IBD surgery performed using the Medtronic Hugo™ RAS is safe and feasible, with similar postoperative outcomes when compared to the laparoscopic approach.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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