Impact of robotic surgery on postoperative gastrointestinal dysfunction following minimally invasive colorectal surgery: incidence, risk factors, and short-term outcomes.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-10-17 DOI:10.1007/s00384-024-04733-5
Guiqi Zhang, Shiquan Pan, Shengfu Yang, Jiashun Wei, Jie Rong, Dongbo Wu
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Abstract

Aim: Postoperative gastrointestinal dysfunction (POGD) is a common complication following colorectal surgery. This study aimed to investigate the incidence and risk factors of POGD after minimally invasive surgery and to assess the relationship between robotic surgery, POGD, and their outcomes.

Method: Patients who had undergone minimally invasive colorectal surgery at our institution between July 2018 and November 2023 were retrospectively enrolled. POGD was diagnosed based on the presence of two or more intestinal symptoms within 72 h or more after surgery. Risk factors were identified through regression analyses, and the impact of POGD on outcomes was assessed using linear regression.The association between those factors was assessed using subgroup analysis and hierarchical regression.

Results: A total of 226 patients were included in the analysis, including 33 with POGD. POGD occurred in 14.6% of patients, with a lower incidence in robotic surgery (7.3%) than in laparoscopic surgery (19.8%). Multivariate analysis indicated that robotic surgery had a protective effect, while blood loss exceeding 50 ml was an independent risk factor for POGD. POGD was also correlated with longer length of stays and higher costs. The association between POGD, length of stay, and cost varied depending on the surgical platform. Robotic surgery exacerbated the effect of POGD on short-term outcomes, which aligned with the observed significant interaction effect.

Conclusion: POGD remains a prevalent postoperative disease. Preventive strategies, including meticulous hemostasis techniques and robotic surgery, should be prioritized by healthcare professionals to reduce POGD risk, improve short-term outcomes, and preserve healthcare resources.

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机器人手术对微创结直肠手术后胃肠道功能障碍的影响:发生率、风险因素和短期疗效。
目的:术后胃肠道功能障碍(POGD)是结直肠手术后常见的并发症。本研究旨在调查微创手术后 POGD 的发生率和风险因素,并评估机器人手术、POGD 及其结果之间的关系:回顾性纳入2018年7月至2023年11月期间在我院接受微创结直肠手术的患者。根据术后 72 小时或更长时间内出现两种或两种以上肠道症状来诊断 POGD。通过回归分析确定了风险因素,并使用线性回归评估了POGD对结果的影响,使用亚组分析和层次回归评估了这些因素之间的关联:结果:共有 226 名患者被纳入分析,其中包括 33 名 POGD 患者。14.6%的患者发生了POGD,机器人手术(7.3%)的发生率低于腹腔镜手术(19.8%)。多变量分析表明,机器人手术具有保护作用,而失血量超过 50 毫升则是 POGD 的独立风险因素。POGD 还与住院时间长和费用高相关。POGD、住院时间和费用之间的关系因手术平台而异。机器人手术加剧了POGD对短期结果的影响,这与观察到的显著交互效应一致:结论:POGD仍然是一种常见的术后疾病。医护人员应优先考虑包括细致止血技术和机器人手术在内的预防策略,以降低 POGD 风险、改善短期疗效并保护医疗资源。
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来源期刊
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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