Froehlich Michael H, Van Roy Isabelle, Krichmar Aleksandr, Mazis Christopher M, Roberts David A, Yelika Suresh B, Ahn Nicholas J, Denoya Paula I, Nagle Deborah A
Department of Surgery, Health Sciences Center (HSC)-19, Stony Brook University Hospital, 101 Nicolls Rd, Stony Brook, NY, 11794, USA.
Division of Colorectal Surgery, Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, 11794, USA.
Surg Endosc. 2025 Jul 14. doi: 10.1007/s00464-025-11918-8.
The purpose of this study was to assess robotic console time and total operative time, as well as post-operative outcomes, in patients undergoing robotic-assisted colostomy reversal.
This was a single institution retrospective review of patients undergoing robotic colostomy reversal from January 2020 to February 2024. Demographics, pre-, intra-, and post-operative data were collected and analyzed to evaluate factors associated with prolonged console and operative times, as well as assess post-operative outcomes.
37 patients underwent robotic-assisted colostomy reversal. 21 patients were male. Mean age was 57.1 years and 87.5% were Caucasian. 40.5% had hypertension, 5.4% had DMII, 2.7% had CHF, 5.4% had CKD, and 5.4% had COPD. 24 (64.9%) had colostomies secondary to perforated diverticulitis, 8.1% due to diverticulitis without frank perforation, 8.1% due to perforated or obstructing colon malignancies, and 5.4% following traumatic colon injuries. 97.3% had fully independent functional statuses. Two cases (5.4%) were converted to open. Mean console time for all cases was 174 min. Mean console time in those who did not undergo pre-operative ureteral stenting or ICG instillation was significantly less (161 min) than those who did (203 min) (p = 0.020). Over the study period, there was no statistically significant decrease in robotic console time (p = 0.982) or total operative time (p = 0.977). Two patients (5.4%) had post-operative rectal bleeding, one of which required transfusion. No patients had post-operative anastomotic leaks. Mean return of bowel function was 2.1 days. Mean length of stay was 3.7 days and 85.3% of patients were discharged within 4 days. One (2.7%) patient was readmitted within 90 days.
Robotic colostomy reversal appears to be a safe and feasible option with a low incidence of complications. Operative time remains long, primarily due to the need for minimally invasive lysis of adhesions. Use of ureteral stenting also contributes to longer console and operative times.
本研究的目的是评估接受机器人辅助结肠造口回纳术患者的机器人控制台操作时间、总手术时间以及术后结果。
这是一项对2020年1月至2024年2月期间接受机器人结肠造口回纳术患者的单机构回顾性研究。收集并分析了人口统计学数据、术前、术中和术后数据，以评估与延长控制台操作时间和手术时间相关的因素，并评估术后结果。
37例患者接受了机器人辅助结肠造口回纳术。21例为男性。平均年龄为57.1岁，87.5%为白种人。40.5%患有高血压，5.4%患有2型糖尿病，2.7%患有充血性心力衰竭，5.4%患有慢性肾脏病，5.4%患有慢性阻塞性肺疾病。24例（64.9%）因穿孔性憩室炎行结肠造口术，8.1%因无明显穿孔的憩室炎，8.1%因穿孔或阻塞性结肠恶性肿瘤，5.4%因结肠外伤后行结肠造口术。97.3%的患者功能状态完全独立。2例（5.4%）转为开放手术。所有病例的平均控制台操作时间为174分钟。未进行术前输尿管支架置入或吲哚菁绿注入的患者平均控制台操作时间（161分钟）明显短于进行了该操作的患者（203分钟）（p = 0.020）。在研究期间，机器人控制台操作时间（p = 0.982）或总手术时间（p = 0.977）没有统计学上的显著下降。2例患者（5.4%）术后出现直肠出血，其中1例需要输血。没有患者发生术后吻合口漏。肠道功能平均恢复时间为2.1天。平均住院时间为3.7天，85.3%的患者在4天内出院。1例（2.7%）患者在90天内再次入院。
机器人结肠造口回纳术似乎是一种安全可行的选择，并发症发生率低。手术时间仍然较长，主要是由于需要进行微创粘连松解。输尿管支架置入的使用也导致控制台操作时间和手术时间延长。
