Rumpf Florian, Choorapoikayil Suma, Hof Lotta, Salari Keyan, Baumhove Olaf, Bayer Alexandra, Friederich Patrick, Friedrich Jens, Elke Gunnar, Gruenewald Matthias, Narita Diana, Raadts Ansgar, Schwendner Klaus, Jenke Dana J, Steinbicker Andrea U, Thoma Josef, Weber Viola, Velten Markus, Wittmann Maria, Weigt Henry, Lange Björn, Zacharowski Kai, Meybohm Patrick
Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany.
Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt, Germany.
Transfus Med Hemother. 2024 Oct 21;52(2):142-151. doi: 10.1159/000540981. eCollection 2025 Apr.
Robotic-assisted surgery is increasingly performed in various surgical disciplines demonstrating improved oncological and functional outcomes compared to conventional surgery.
Unclear is how robotic-assisted surgery affects perioperative anemia and the need for blood products.
In this case-control study, 15,009 matched patient pairs undergoing urological, visceral, or thoracic surgery were included. Pairwise comparisons between robotic-assisted surgery, laparoscopic surgery, and open surgery were performed with propensity score matching.
Robotic-assisted surgery compared to open surgery was associated with a risk reduction of allogeneic red blood cell transfusion by RR: 0.32 (95% CI: 0.27-0.37) and a limited reduction of perioperative hemoglobin (perioperative hemoglobin difference of 0.40 g/dL, 95% CI: 0.31-0.49). Robotic-assisted surgery was associated with a shorter length of hospital stay by 4.29 days (95% CI: 3.74-4.84). Compared to laparoscopic surgery, robotic-assisted surgery had no significant effect on red blood cell transfusions (RR: 0.94, 95% CI: 0.75-1.18), perioperative hemoglobin (0.27 g/dL, 95% CI: 0.16-0.38), or length of hospital stay 0.53 days (95% CI: -0.14-1.19).
Robotic-assisted and laparoscopic procedures are associated with reduced blood transfusions compared to open surgery and, thus the advancement of minimally invasive procedures constitutes an important measure to improve patient outcomes.
机器人辅助手术在各个外科领域的应用日益广泛，与传统手术相比，其肿瘤学和功能预后均有所改善。
目前尚不清楚机器人辅助手术如何影响围手术期贫血及血液制品的需求。
在这项病例对照研究中，纳入了15009对接受泌尿外科、内脏或胸科手术的匹配患者。采用倾向评分匹配法对机器人辅助手术、腹腔镜手术和开放手术进行成对比较。
与开放手术相比，机器人辅助手术使异体红细胞输血风险降低，风险比（RR）为0.32（95%置信区间：0.27 - 0.37），围手术期血红蛋白降低有限（围手术期血红蛋白差异为0.40 g/dL，95%置信区间：0.31 - 0.49）。机器人辅助手术使住院时间缩短4.29天（95%置信区间：3.74 - 4.84）。与腹腔镜手术相比，机器人辅助手术对红细胞输血（RR：0.94，95%置信区间：0.75 - 1.18）、围手术期血红蛋白（0.27 g/dL，95%置信区间：0.16 - 0.38）或住院时间（0.53天，95%置信区间： - 0.14 - 1.19）无显著影响。
与开放手术相比，机器人辅助手术和腹腔镜手术与输血减少相关，因此微创技术的进步是改善患者预后的重要措施。
