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Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes
Study design Because of current demographic developments, a hypothesis was proposed whereby older female patients aged > 65 years can be safely operated using minimally invasive, robotic-assisted surgery, despite having more preoperative comorbidities. A comparative cohort study was designed to c...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155232/ https://www.ncbi.nlm.nih.gov/pubmed/37153652 http://dx.doi.org/10.1055/a-1902-4577 |
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author | Mothes, Anke R. Kather, Angela Cepraga, Irina Esber, Anke Kwetkat, Anja Runnebaum, Ingo B. |
author_facet | Mothes, Anke R. Kather, Angela Cepraga, Irina Esber, Anke Kwetkat, Anja Runnebaum, Ingo B. |
author_sort | Mothes, Anke R. |
collection | PubMed |
description | Study design Because of current demographic developments, a hypothesis was proposed whereby older female patients aged > 65 years can be safely operated using minimally invasive, robotic-assisted surgery, despite having more preoperative comorbidities. A comparative cohort study was designed to compare the age group ≥ 65 years (older age group, OAG) with the age group < 65 years (younger age group, YAG) after robotic-assisted gynecological surgery (RAS) in two German centers. Patients and methods Consecutive RAS procedures performed between 2016 and 2021 at the Women’s University Hospital of Jena and the Robotic Center Eisenach to treat benign or oncological indications were included in the study. The age groups were compared according to their preoperative comorbidities (ASA, Charlson comorbidity index [CCI], cumulative illness rating scale – geriatric version [CIRS-G]) and perioperative parameters such as Clavien-Dindo (CD) classification of surgical complications. Analysis was performed using Welch’s t -test, chi (2) test, and Fisher’s exact test. Results A total of 242 datasets were identified, of which 63 (73 ± 5 years) were OAG and 179 were YAG (48 ± 10 years). Patient characteristics and the percentage of benign or oncological indications did not differ between the two age groups. Comorbidity scores and the percentage of obese patients were higher in the OAG group: CCI (2.7 ± 2.0 vs. 1.5 ± 1.3; p < 0.001), CIRS-G (9.7 ± 3.9 vs. 5.4 ± 2.9; p < 0.001), ASA class II/III (91.8% vs. 74.1%; p = 0.004), obesity (54.1% vs. 38.2%; p = 0.030). There was no difference between age groups, even grouped for benign or oncological indications, with regard to perioperative parameters such as duration of surgery (p = 0.088; p = 0.368), length of hospital stay (p = 0.786; p = 0.814), decrease in Hb levels (p = 0.811; p = 0.058), conversion rate (p = 1.000; p = 1.000) and CD complications (p = 0.433; p = 0.745). Conclusion Although preoperative comorbidity was higher in the group of older female patients, no differences were found between age groups with regard to perioperative outcomes following robotic-assisted gynecological surgery. Patient age is not a contraindication for robotic gynecological surgery. |
format | Online Article Text |
id | pubmed-10155232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-101552322023-05-04 Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes Mothes, Anke R. Kather, Angela Cepraga, Irina Esber, Anke Kwetkat, Anja Runnebaum, Ingo B. Geburtshilfe Frauenheilkd Study design Because of current demographic developments, a hypothesis was proposed whereby older female patients aged > 65 years can be safely operated using minimally invasive, robotic-assisted surgery, despite having more preoperative comorbidities. A comparative cohort study was designed to compare the age group ≥ 65 years (older age group, OAG) with the age group < 65 years (younger age group, YAG) after robotic-assisted gynecological surgery (RAS) in two German centers. Patients and methods Consecutive RAS procedures performed between 2016 and 2021 at the Women’s University Hospital of Jena and the Robotic Center Eisenach to treat benign or oncological indications were included in the study. The age groups were compared according to their preoperative comorbidities (ASA, Charlson comorbidity index [CCI], cumulative illness rating scale – geriatric version [CIRS-G]) and perioperative parameters such as Clavien-Dindo (CD) classification of surgical complications. Analysis was performed using Welch’s t -test, chi (2) test, and Fisher’s exact test. Results A total of 242 datasets were identified, of which 63 (73 ± 5 years) were OAG and 179 were YAG (48 ± 10 years). Patient characteristics and the percentage of benign or oncological indications did not differ between the two age groups. Comorbidity scores and the percentage of obese patients were higher in the OAG group: CCI (2.7 ± 2.0 vs. 1.5 ± 1.3; p < 0.001), CIRS-G (9.7 ± 3.9 vs. 5.4 ± 2.9; p < 0.001), ASA class II/III (91.8% vs. 74.1%; p = 0.004), obesity (54.1% vs. 38.2%; p = 0.030). There was no difference between age groups, even grouped for benign or oncological indications, with regard to perioperative parameters such as duration of surgery (p = 0.088; p = 0.368), length of hospital stay (p = 0.786; p = 0.814), decrease in Hb levels (p = 0.811; p = 0.058), conversion rate (p = 1.000; p = 1.000) and CD complications (p = 0.433; p = 0.745). Conclusion Although preoperative comorbidity was higher in the group of older female patients, no differences were found between age groups with regard to perioperative outcomes following robotic-assisted gynecological surgery. Patient age is not a contraindication for robotic gynecological surgery. Georg Thieme Verlag KG 2023-04-05 /pmc/articles/PMC10155232/ /pubmed/37153652 http://dx.doi.org/10.1055/a-1902-4577 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Mothes, Anke R. Kather, Angela Cepraga, Irina Esber, Anke Kwetkat, Anja Runnebaum, Ingo B. Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes |
title | Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes |
title_full | Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes |
title_fullStr | Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes |
title_full_unstemmed | Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes |
title_short | Robotic-assisted Gynecological Surgery in Older Patients – a Comparative Cohort Study of Perioperative Outcomes |
title_sort | robotic-assisted gynecological surgery in older patients – a comparative cohort study of perioperative outcomes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155232/ https://www.ncbi.nlm.nih.gov/pubmed/37153652 http://dx.doi.org/10.1055/a-1902-4577 |
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