Elevated respiratory complications following robotic-assisted lobectomy: A national cohort analysis of 26,140 cases

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-09-24 DOI:10.1002/rcs.2581

Ruijian Huang, Yue Xiao, Feng Jiang, Yanfei Chen, Cunhua Su, Jifang Zhou, Tianchi Yang

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Abstract

Background

Robotic-assisted lobectomy (RL) is increasingly used nationally, but little comparative data exist on its safety compared with open lobectomy (OL) or video-assisted lobectomy (VL). This study aimed to estimate the risk of perioperative complications for RL, VL, or OL.

Methods

Admissions were identified from the hospital administrative data collected between 2015 and 2019. Propensity score matching and inverse probabilistic weighting were used to account for selection bias. Logistic and quantile regression models were applied to determine perioperative outcome differences.

Results

We identified 26,140 cases of which 5337 (20.4%), 12,680 (48.5%), and 8123 (31.1%) underwent RL, VL, and OL. RL and VL were associated with lower complication rates, shorter lengths of stay, and fewer mortality risks. RL was associated with significantly elevated risks for perioperative respiratory complications (adjusted odds ratio 1.10, p = 0.010).

Conclusion

Relatively low rates of perioperative complications for VL and RL, and higher respiratory complication rates in RL are concerning.

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机器人辅助肺叶切除术后呼吸道并发症增加：26140例病例的全国队列分析。

背景：机器人辅助肺叶切除术（RL）在全国范围内越来越多地使用，但与开放式肺叶切除术或电视辅助肺叶切除术（VL）相比，几乎没有关于其安全性的比较数据。本研究旨在评估RL、VL或OL围手术期并发症的风险。方法：根据2015年至2019年期间收集的医院管理数据确定入院人数。倾向性得分匹配和反概率加权被用来解释选择偏差。应用Logistic和分位数回归模型来确定围手术期结果的差异。结果：我们确定了26140例病例，其中5337例（20.4%）、12680例（48.5%）和8123例（31.1%）接受了RL、VL和OL。RL和VL与较低的并发症发生率、较短的住院时间和较低的死亡率相关。RL与围手术期呼吸系统并发症的风险显著升高相关（调整比值比1.10，p=0.010）。结论：VL和RL的围手术期并发症发生率相对较低，RL的呼吸系统并发症发生率较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.