Global benchmarks in primary robotic bariatric surgery redefine quality standards for Roux-en-Y gastric bypass and sleeve gastrectomy.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Giudicelli Guillaume, Gero Daniel, Romulo Lind, Chirumamilla Vasu, Iranmanesh Pouya, Owen Christopher K, Bauerle Wayne, Garcia Amador, Lucas Lisa, Mehdorn Anne-Sophie, Pandey Dhananjay, Almuttawa Abdullah, Cabral Francisco, Tiwari Abhishek, Lambert Virginia, Pascotto Beniamino, De Meyere Celine, Yahyaoui Marouan, Haist Thomas, Scheffel Oliver, Robert Maud, Nuytens Frederiek, Azagra Santiago, Kow Lilian, Prasad Arun, Vaz Carlos, Vix Michel, Bindal Vivek, Beckmann Jan H, Soussi David, Vilallonga Ramon, El Chaar Maher, Wilson Erik B, Ahmad Arif, Teixeira Andre, Hagen Monika E, Toso Christian, Clavien Pierre-Alain, Puhan Milo, Bueter Marco, Jung Minoa K
Аннотация
METHODS: Benchmark cut-offs were established for consecutive primary robotic bariatric surgery patients of 17 centres across four continents (13 expert centres and 4 learning phase centres) using the 75th percentile of the median outcome values until 90 days after surgery. The benchmark patients had no previous laparotomy, diabetes, sleep apnoea, cardiopathy, renal insufficiency, inflammatory bowel disease, immunosuppression, history of thromboembolic events, BMI greater than 50 kg/m2, or age greater than 65 years.
RESULTS: A total of 9097 patients were included, who were mainly female (75.5%) and who had a mean(s.d.) age of 44.7(11.5) years and a mean(s.d.) baseline BMI of 44.6(7.7) kg/m2. In expert centres, 13.74% of the 3020 patients who underwent primary robotic Roux-en-Y gastric bypass and 5.9% of the 4078 patients who underwent primary robotic sleeve gastrectomy presented with greater than or equal to one complication within 90 postoperative days. No patient died and 1.1% of patients had adverse events related to the robotic platform. When compared with laparoscopic benchmarks, robotic Roux-en-Y gastric bypass had lower benchmark cut-offs for hospital stay, postoperative bleeding, and marginal ulceration, but the duration of the operation was 42 min longer. For most surgical outcomes, robotic sleeve gastrectomy outperformed laparoscopic sleeve gastrectomy with a comparable duration of the operation. In robotic learning phase centres, outcomes were within the established benchmarks only for low-risk robotic Roux-en-Y gastric bypass.
CONCLUSION: The newly established benchmarks suggest that robotic bariatric surgery may enhance surgical safety compared with laparoscopic bariatric surgery; however, the duration of the operation for robotic Roux-en-Y gastric bypass is longer.