{"id":26179,"date":"2024-08-13T04:05:00","date_gmt":"2024-08-12T20:05:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=26179"},"modified":"2024-08-13T05:48:20","modified_gmt":"2024-08-12T21:48:20","slug":"jama-surg%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%be%ae%e5%88%9b%e6%89%8b%e6%9c%af%e6%97%b6%e4%bb%a3%e6%99%ae%e9%80%9a%e5%a4%96%e7%a7%91%e6%80%a5%e8%af%8a%e6%89%8b%e6%9c%af%e7%9a%84%e6%9c%ba","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=26179","title":{"rendered":"[JAMA Surg\u53d1\u8868\u8bba\u6587]\uff1a\u5fae\u521b\u624b\u672f\u65f6\u4ee3\u666e\u901a\u5916\u79d1\u6025\u8bca\u624b\u672f\u7684\u673a\u5668\u4eba\u6280\u672f"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

March 6, 2024<\/p>\n\n\n\n

Robotic Technology in Emergency General Surgery Cases in the Era of Minimally Invasive Surgery<\/h1>\n\n\n\n

Nicole Lunardi, Aida Abou-Zamzam, Katherine L. Florecki, et al<\/h3>\n\n\n\n

JAMA Surg. <\/em>2024;159(5):493-499. doi:10.1001\/jamasurg.2024.0016<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Do outcomes for emergency general surgery vary by surgical approach?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study of more than 1 million procedures, robotic surgery was more prevalent for emergency general surgery between 2013 and 2021. Robotic surgery, compared with laparoscopic surgery, is associated with decreased conversion to open surgery and decreased postoperative length of stay in commonly performed urgent and emergent procedures.<\/p>\n\n\n\n

Meaning<\/strong>  The findings of this study suggest that robotic surgery may be associated with better surgical outcomes in emergent general surgery, similar to previous findings in elective operations.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Although robotic surgery has become an established approach for a wide range of elective operations, data on its utility and outcomes are limited in the setting of emergency general surgery.<\/p>\n\n\n\n

Objectives<\/strong>  To describe temporal trends in the use of laparoscopic and robotic approaches and compare outcomes between robotic and laparoscopic surgery for 4 common emergent surgical procedures.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  A retrospective cohort study of an all-payer discharge database of 829 US facilities was conducted from calendar years 2013 to 2021. Data analysis was performed from July 2022 to November 2023. A total of 1\u202f067\u202f263 emergent or urgent cholecystectomies (n\u2009=\u2009793\u202f800), colectomies (n\u2009=\u200989\u202f098), inguinal hernia repairs (n\u2009=\u200965\u202f039), and ventral hernia repairs (n\u2009=\u2009119\u202f326) in patients aged 18 years or older were included.<\/p>\n\n\n\n

Exposure<\/strong>  Surgical approach (robotic, laparoscopic, or open) to emergent or urgent cholecystectomy, colectomy, inguinal hernia repair, or ventral hernia repair.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was the temporal trend in use of each operative approach (laparoscopic, robotic, or open). Secondary outcomes included conversion to open surgery and length of stay (both total and postoperative). Temporal trends were measured using linear regression. Propensity score matching was used to compare secondary outcomes between robotic and laparoscopic surgery groups.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0During the study period, the use of robotic surgery increased significantly year-over-year for all procedures: 0.7% for cholecystectomy, 0.9% for colectomy, 1.9% for inguinal hernia repair, and 1.1% for ventral hernia repair. There was a corresponding decrease in the open surgical approach for all cases. Compared with laparoscopy, robotic surgery was associated with a significantly lower risk of conversion to open surgery: cholecystectomy, 1.7% vs 3.0% (odds ratio [OR],\u20090.55 [95% CI, 0.49-0.62]); colectomy, 11.2% vs 25.5% (OR, 0.37 [95% CI, 0.32-0.42]); inguinal hernia repair, 2.4% vs 10.7% (OR, 0.21 [95% CI, 0.16-0.26]); and ventral hernia repair, 3.5% vs 10.9% (OR, 0.30 [95% CI, 0.25-0.36]). Robotic surgery was associated with shorter postoperative lengths of stay for colectomy (\u22120.48 [95% CI, \u22120.60 to \u22120.35] days), inguinal hernia repair (\u22120.20 [95% CI, \u22120.30 to \u22120.10] days), and ventral hernia repair (\u22120.16 [95% CI, \u22120.26 to \u22120.06] days).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>  While robotic surgery is still not broadly used for emergency general surgery, the findings of this study suggest it is becoming more prevalent and may be associated with better outcomes as measured by reduced conversion to open surgery and decreased length of stay.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  March 6, 2024 Robotic Tech […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26179"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=26179"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26179\/revisions"}],"predecessor-version":[{"id":26538,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/26179\/revisions\/26538"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=26179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=26179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=26179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}