Short-term postoperative outcomes following robotic versus laparoscopic ileal pouch-anal anastomosis are equivalent.

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Serval ID
serval:BIB_6508C22E13F4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Short-term postoperative outcomes following robotic versus laparoscopic ileal pouch-anal anastomosis are equivalent.
Journal
Techniques in coloproctology
Author(s)
Lightner A.L., Grass F., McKenna N.P., Tilman M., Alsughayer A., Kelley S.R., Behm K., Merchea A., Larson D.W.
ISSN
1128-045X (Electronic)
ISSN-L
1123-6337
Publication state
Published
Issued date
03/2019
Peer-reviewed
Oui
Volume
23
Number
3
Pages
259-266
Language
english
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Abstract
Minimally invasive approaches have become the standard of care for ileal pouch-anal anastomoses (IPAA). There are few reports comparing outcomes following a laparoscopic versus robotic approach. Our aim was to determine if there were any differences in the 30-day postoperative outcomes following IPAA performed laparoscopically versus robotically.
A retrospective chart review of all laparoscopic and robotic IPAA performed between January 1, 2015 and June 30, 2018 was carried out. Patients included were adult patients who underwent a proctectomy and IPAA utilizing either a laparoscopic or robotic approach. Data collected included patient demographics, operative variables, and 30-day postoperative outcomes.
A total of 132 patients had a minimally invasive IPAA; 58 were performed laparoscopically and 74 robotically. Less than half the patients were female (n = 55; 41.7%) with a median age of 37 years (range 18-68 years). The majority of patients had a diagnosis of ulcerative colitis (n = 103; 78.0%) with medically refractory disease (n = 87; 65.9%). A greater proportion of patients in the laparoscopic cohort had a prolonged length of stay (n = 27; 46.6% versus n = 18; 24.3%; p < 0.001) and a two-stage approach (n = 56; 96.6% versus n = 37; 50%; p < 0.001), but there were no differences in the rates between the laparoscopic versus robotic cohorts of superficial surgical site infection (6.9% versus 6.8%; p = 0.99), peripouch abscess (15.5% versus 6.8%; p = 0.11), anastomotic leak (6.9% versus 2.7%; p = 0.21), pelvic abscess (15.5% versus 6.8%; p = 0.11), and pelvic sepsis (15.5% versus 6.8%; p = 0.11), readmission (24.1% versus 17.6%; p = 0.35) or reoperation (6.9% versus 5.4%; p = 0.72). On multivariable analysis, only male sex remained predictive of prolonged length of stay, and a robotic approach trended toward a decreased rate of prolonged length of stay.
Laparoscopic and robotic IPAA have equivalent postoperative morbidity underscoring the safety of the continued expansion of the robotic platform for pouch surgery.
Keywords
Adolescent, Adult, Aged, Colitis, Ulcerative/surgery, Female, Humans, Laparoscopy/methods, Laparoscopy/statistics & numerical data, Male, Middle Aged, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Proctocolectomy, Restorative/methods, Retrospective Studies, Robotic Surgical Procedures/methods, Robotic Surgical Procedures/statistics & numerical data, Treatment Outcome, Young Adult, Ileal pouch-anal anastomosis, Minimally invasive surgery, Proctocolectomy, Restorative, Robotic surgical procedures
Pubmed
Web of science
Create date
29/11/2021 14:01
Last modification date
30/11/2021 7:10
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