A comparison of outcomes between laparoscopic and robotic appendectomy among ACS-NSQIP hospitals  

作　　者：Timothy Becker Genaro DeLeon Varun Rao Kevin Y.Pei 

机构地区：[1]Indiana University School of Medicine,340 W 10th St,Indianapolis,IN 46202,USA [2]Parkview Health General Surgery Graduate Medical Education,2200 Randallia Dr,Fort Wayne,IN 46805,USA

出　　处：《Laparoscopic, Endoscopic and Robotic Surgery》2023年第2期39-42,共4页腔镜、内镜与机器人外科（英文）

摘　　要：Objective:Robotic general surgery remains controversial,with some employing the technology for common laparoscopic procedures such as appendectomies.Very few studies have compared robotic appendectomy(RA)to existing techniques,partly due to the relative scarcity of data.The purpose of this study was to compare outcomes for RA versus laparoscopic appendectomy(LA).Methods:This retrospective cohort study evaluated procedural specific databases of the American Col-lege of Surgeons National Surgical Quality Improvement Program(ACS-NSQIP)for appendectomy be-tween January 2016 and December 2019 and included all available cases at the time of analysis(June 2021).Demographic and surgical outcomes including composite 30-day complications,specific com-plications,and length of operation were analyzed using a univariate analysis.Results:In total,there were 52,559 appendectomies in the NSQIP database between 2016 and 2019.Analysis was restricted to those who underwent minimally invasive approaches.In total,49,850 patients were included in the analysis.Of those,49,800 patients underwent LA,and 50 patients underwent RA.Participants who underwent RA were older(35.8±4.5 y vs.23.0±0.2 y,p<0.01).There was no dif-ference in the total number of comorbidities(92.0%vs.73.4%,p=0.32)or the severity of appendicitis(p>0.90)between RA and LA cases.RA had a longer median operation time(71.0 min vs.46.0 min,p<0.01)but a shorter postoperative stay(0.7 d vs.1.3 d,p<0.01).There was no difference in the frequency of readmission likely related to procedure(4.0%vs.3.0%,p=0.88)or complications(18.0%vs.23.8%,p=0.88);however,RA was associated with increased 30-day mortality(2.0%vs.<0.1%,p<0.01)compared to LA.Conclusion:Our results demonstrated that LA and RA had a similar frequency and profile of complica-tions.Robotic procedures took longer but resulted in shorter postoperative stays.Our study revealed that RA constituted a mere 0.1%of all cases,with only 50% showing pathology consistent with appendicitis,despite 92.2%of LA cases presenting with the

关 键 词：Robotics APPENDECTOMY General surgery NSQIP Postoperative complication 

分 类 号：R656.8[医药卫生—外科学]