Cargando…
Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center
Background: Robotic-assisted colorectal surgery is gaining popularity, but limited data are available on the safety, efficacy, and cost of robotic-assisted restorative proctectomy with the construction of an ileal pouch and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). Methods: A...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657553/ https://www.ncbi.nlm.nih.gov/pubmed/36362789 http://dx.doi.org/10.3390/jcm11216561 |
_version_ | 1784829726467031040 |
---|---|
author | Gebhardt, Jasper Max Werner, Neno Stroux, Andrea Förster, Frank Pozios, Ioannis Seifarth, Claudia Schineis, Christian Kamphues, Carsten Weixler, Benjamin Beyer, Katharina Lauscher, Johannes Christian |
author_facet | Gebhardt, Jasper Max Werner, Neno Stroux, Andrea Förster, Frank Pozios, Ioannis Seifarth, Claudia Schineis, Christian Kamphues, Carsten Weixler, Benjamin Beyer, Katharina Lauscher, Johannes Christian |
author_sort | Gebhardt, Jasper Max |
collection | PubMed |
description | Background: Robotic-assisted colorectal surgery is gaining popularity, but limited data are available on the safety, efficacy, and cost of robotic-assisted restorative proctectomy with the construction of an ileal pouch and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). Methods: A retrospective study was conducted comparing consecutively performed robotic-assisted and laparoscopic proctectomy with IPAA between 1 January 2016 and 31 September 2021. In total, 67 adult patients with medically refractory UC without proven dysplasia or carcinoma underwent surgery: 29 operated robotically and 38 laparoscopically. Results: There were no differences between both groups regarding postoperative complications within 30 days according to Clavien-Dindo classification’ grades 1–5 (51.7% vs. 42.1%, p = 0.468) and severe grades 3b–5 (17.2% vs. 10.5%, p = 0.485). Robotic-assisted surgery was associated with an increased urinary tract infection rate (n = 7, 24.1% vs. n = 1, 2.6%; p = 0.010) and longer operative time (346 ± 65 min vs. 281 ± 66 min; p < 0.0001). Surgery costs were higher when operated robotically (median EUR 10.377 [IQR EUR 4.727] vs. median EUR 6.689 [IQR EUR 3.170]; p < 0.0001), resulting in reduced total inpatient profits (median EUR 110 [IQR EUR 4.971] vs. median EUR 2.853 [IQR EUR 5.386]; p = 0.001). Conclusion: Robotic-assisted proctectomy with IPAA can be performed with comparable short-term clinical outcomes to laparoscopy but is associated with a longer duration of surgery and higher surgery costs. As experience increases, some advantages may become evident regarding operative time, postoperative recovery, and length of stay. The robotic procedure might then become cost-efficient. |
format | Online Article Text |
id | pubmed-9657553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-96575532022-11-15 Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center Gebhardt, Jasper Max Werner, Neno Stroux, Andrea Förster, Frank Pozios, Ioannis Seifarth, Claudia Schineis, Christian Kamphues, Carsten Weixler, Benjamin Beyer, Katharina Lauscher, Johannes Christian J Clin Med Article Background: Robotic-assisted colorectal surgery is gaining popularity, but limited data are available on the safety, efficacy, and cost of robotic-assisted restorative proctectomy with the construction of an ileal pouch and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). Methods: A retrospective study was conducted comparing consecutively performed robotic-assisted and laparoscopic proctectomy with IPAA between 1 January 2016 and 31 September 2021. In total, 67 adult patients with medically refractory UC without proven dysplasia or carcinoma underwent surgery: 29 operated robotically and 38 laparoscopically. Results: There were no differences between both groups regarding postoperative complications within 30 days according to Clavien-Dindo classification’ grades 1–5 (51.7% vs. 42.1%, p = 0.468) and severe grades 3b–5 (17.2% vs. 10.5%, p = 0.485). Robotic-assisted surgery was associated with an increased urinary tract infection rate (n = 7, 24.1% vs. n = 1, 2.6%; p = 0.010) and longer operative time (346 ± 65 min vs. 281 ± 66 min; p < 0.0001). Surgery costs were higher when operated robotically (median EUR 10.377 [IQR EUR 4.727] vs. median EUR 6.689 [IQR EUR 3.170]; p < 0.0001), resulting in reduced total inpatient profits (median EUR 110 [IQR EUR 4.971] vs. median EUR 2.853 [IQR EUR 5.386]; p = 0.001). Conclusion: Robotic-assisted proctectomy with IPAA can be performed with comparable short-term clinical outcomes to laparoscopy but is associated with a longer duration of surgery and higher surgery costs. As experience increases, some advantages may become evident regarding operative time, postoperative recovery, and length of stay. The robotic procedure might then become cost-efficient. MDPI 2022-11-04 /pmc/articles/PMC9657553/ /pubmed/36362789 http://dx.doi.org/10.3390/jcm11216561 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gebhardt, Jasper Max Werner, Neno Stroux, Andrea Förster, Frank Pozios, Ioannis Seifarth, Claudia Schineis, Christian Kamphues, Carsten Weixler, Benjamin Beyer, Katharina Lauscher, Johannes Christian Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center |
title | Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center |
title_full | Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center |
title_fullStr | Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center |
title_full_unstemmed | Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center |
title_short | Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center |
title_sort | robotic-assisted versus laparoscopic proctectomy with ileal pouch-anal anastomosis for ulcerative colitis: an analysis of clinical and financial outcomes from a tertiary referral center |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657553/ https://www.ncbi.nlm.nih.gov/pubmed/36362789 http://dx.doi.org/10.3390/jcm11216561 |
work_keys_str_mv | AT gebhardtjaspermax roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT wernerneno roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT strouxandrea roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT forsterfrank roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT poziosioannis roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT seifarthclaudia roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT schineischristian roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT kamphuescarsten roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT weixlerbenjamin roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT beyerkatharina roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter AT lauscherjohanneschristian roboticassistedversuslaparoscopicproctectomywithilealpouchanalanastomosisforulcerativecolitisananalysisofclinicalandfinancialoutcomesfromatertiaryreferralcenter |