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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Differences in Effectiveness and Use of Robotic Surgery in Patients Undergoing Minimally Invasive Colectomy
Journal of gastrointestinal surgery, v 21(8), pp 1296-1303
01 Aug 2017
PMID: 28567574
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background We compared patient outcomes of robot-assisted surgery (RAS) and laparoscopic colectomy without robotic assistance for colon cancer or nonmalignant polyps, comparing all patients, obese versus nonobese patients, and male versus female patients. Methods We used the 2013-2015 American College of Surgeons National Surgical Quality Improvement Program data to examine a composite outcome score comprised of mortality, readmission, reoperation, wound infection, bleeding transfusion, and prolonged postoperative ileus. We used propensity scores to assess potential heterogeneous treatment effects of RAS by patient obesity and sex. Results In all, 17.1% of the 10,844 of patients received RAS. Males were slightly more likely to receive RAS. Obese patients were equally likely to receive RAS as nonobese patients. In comparison to nonRAS, RAS was associated with a 3.1% higher adverse composite outcome score. Mortality, reoperations, wound infections, sepsis, pulmonary embolisms, deep vein thrombosis, myocardial infarction, blood transfusions, and average length of hospitalization were similar in both groups. Conversion to open surgery was 10.1% lower in RAS versus nonRAS patients, but RAS patients were in the operating room an average of 52.4 min longer. We found no statistically significant differences (p > 0.05) by obesity status and gender. Conclusions Worse patient outcomes and no differential improvement by sex or obesity suggest more cautious adoption of RAS.
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Details
- Title
- Differences in Effectiveness and Use of Robotic Surgery in Patients Undergoing Minimally Invasive Colectomy
- Creators
- M Schootman - Saint Louis UniversityS Hendren - University of MichiganT Loux - Saint Louis UniversityK Ratnapradipa - Saint Louis UniversityJ Eberth - University of South CarolinaNo Davidson
- Publication Details
- Journal of gastrointestinal surgery, v 21(8), pp 1296-1303
- Publisher
- Springer Nature B.V
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy
- Web of Science ID
- WOS:000406026400013
- Scopus ID
- 2-s2.0-85020128828
- Other Identifier
- 991021855178004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Gastroenterology & Hepatology
- Surgery