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Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study

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World Journal of Gastrointestinal Surgery 2020年第6期12卷 287-297页

作者： Fulvio Tagliabue Morena Burati Marco Chiarelli Luca Fumagalli Angelo Guttadauro elisa arborio Matilde De Simone Ugo Cioffi Department of Robotic and Emergency Surgery Ospedale A.ManzoniASST LeccoLecco 23900Italy Department of Surgery University of Milan-BicoccaIstituti Clinici ZucchiMonza 20900Italy Department of Surgery University of MilanMilano 20122Italy

BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically *** surgery has been introduced to overcome this technical limitation,but it is related to high *** maximize the benefits of such surgery,only selected patients are candidates for this *** addition,due to progressive aging of the population,an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities,who are usually more prone to post-operative *** To investigate the outcomes of RRH vs LRH with regard to age and *** We retrospectively analyzed 123 minimally invasive procedures(68 LRHs vs 55 RRHs)for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September *** surgical procedures were performed according to standardized *** primary clinical outcome of the study was the length of hospital stay(LOS)measured in *** outcomes were time to first flatus(TFF)and time to first stool *** robotic technique was considered the exposure and the laparoscopic technique was considered the *** demographic variables were obtained,including age at time of surgery and *** mass index and American Society of Anesthesiologists physical status were *** age-adjusted Charlson Comorbidity Index(ACCI)was calculated;the tumornode-metastasis system,intra-operative variables and post-operative complications were ***-operative follow-up was 180 *** LOS,TFF,and time to first stool were significantly shorter in the robotic group:Median 6[interquartile range(IQR)5-8]vs 7(IQR 6-10.5)d,P=0.028;median 2(IQR 1-3)vs 3(IQR 2-4)d,P<0.001;median 4(IQR 3-5)vs 5(IQR 4-6.5)d,P=0.005,*** multivariable analysis,the robotic technique was confirmed to be predictive

关键词： Right hemicolectomy Robotic surgery Laparoscopic surgery Elderly patients Comorbidity Hospital stay

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