Tags

Type your tag names separated by a space and hit enter

Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review.
Tech Coloproctol 2018; 22(3):161-177TC

Abstract

The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis. Primary outcomes included mortality and postoperative complications. Secondary outcomes included readmission rate, length of stay, conversion rate, procedure time, estimated blood loss and functional outcome. The tertiary outcome was cost-effectiveness. Eight studies (3 case-matched observational studies, 4 case series and 1 case report) met the inclusion criteria. There was no reported mortality. Overall, complications occurred in 81 patients (54%) including 30 (20%) Clavien-Dindo III-IV complications. Mean length of stay was 8.6 days. Eleven cases (7.3%) were converted to open. The mean robotic operating time was 99 min out of a mean total operating time of 298.6 min. Thirty-two patients (24.7%) were readmitted. Functional outcomes were comparable among robotic, laparoscopic and open approaches. Case-matched observational studies comparing robotic to laparoscopic surgery revealed a significantly longer procedure time; however, conversion, complication, length of stay and readmission rates were similar. The case-matched observational study comparing robotic to open surgery also revealed a longer procedure time and a higher readmission rate; postoperative complication rates and length of stay were similar. No studies compared cost-effectiveness between robotic and traditional approaches. Although robotic resections for inflammatory bowel disease are technically feasible, outcomes must be interpreted with caution due to low-quality studies.

Authors+Show Affiliations

Department of Surgery, Whittington Hospital NHS Trust, London, UK.Department of Surgery, Whittington Hospital NHS Trust, London, UK.National Centre for Bowel Research and Surgical Innovation, Queen Mary University of London, London, UK. alex007@doctors.org.uk. Department of Surgery, The Royal London Hospital, London, UK. alex007@doctors.org.uk.Digestive Disease Center, Cleveland Clinic Florida, Fort Lauderdale, FL, USA.Department of Surgery, Imperial College, London, UK.Department of Surgery, Whittington Hospital NHS Trust, London, UK.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

29546470

Citation

Renshaw, S, et al. "Perioperative Outcomes and Adverse Events of Robotic Colorectal Resections for Inflammatory Bowel Disease: a Systematic Literature Review." Techniques in Coloproctology, vol. 22, no. 3, 2018, pp. 161-177.
Renshaw S, Silva IL, Hotouras A, et al. Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review. Tech Coloproctol. 2018;22(3):161-177.
Renshaw, S., Silva, I. L., Hotouras, A., Wexner, S. D., Murphy, J., & Bhan, C. (2018). Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review. Techniques in Coloproctology, 22(3), pp. 161-177. doi:10.1007/s10151-018-1766-5.
Renshaw S, et al. Perioperative Outcomes and Adverse Events of Robotic Colorectal Resections for Inflammatory Bowel Disease: a Systematic Literature Review. Tech Coloproctol. 2018;22(3):161-177. PubMed PMID: 29546470.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review. AU - Renshaw,S, AU - Silva,I L, AU - Hotouras,A, AU - Wexner,S D, AU - Murphy,J, AU - Bhan,C, Y1 - 2018/03/15/ PY - 2017/11/22/received PY - 2018/02/05/accepted PY - 2018/3/17/pubmed PY - 2018/10/23/medline PY - 2018/3/17/entrez KW - Colorectal resection KW - Inflammatory bowel disease KW - Robotic surgical procedures SP - 161 EP - 177 JF - Techniques in coloproctology JO - Tech Coloproctol VL - 22 IS - 3 N2 - The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis. Primary outcomes included mortality and postoperative complications. Secondary outcomes included readmission rate, length of stay, conversion rate, procedure time, estimated blood loss and functional outcome. The tertiary outcome was cost-effectiveness. Eight studies (3 case-matched observational studies, 4 case series and 1 case report) met the inclusion criteria. There was no reported mortality. Overall, complications occurred in 81 patients (54%) including 30 (20%) Clavien-Dindo III-IV complications. Mean length of stay was 8.6 days. Eleven cases (7.3%) were converted to open. The mean robotic operating time was 99 min out of a mean total operating time of 298.6 min. Thirty-two patients (24.7%) were readmitted. Functional outcomes were comparable among robotic, laparoscopic and open approaches. Case-matched observational studies comparing robotic to laparoscopic surgery revealed a significantly longer procedure time; however, conversion, complication, length of stay and readmission rates were similar. The case-matched observational study comparing robotic to open surgery also revealed a longer procedure time and a higher readmission rate; postoperative complication rates and length of stay were similar. No studies compared cost-effectiveness between robotic and traditional approaches. Although robotic resections for inflammatory bowel disease are technically feasible, outcomes must be interpreted with caution due to low-quality studies. SN - 1128-045X UR - https://www.unboundmedicine.com/medline/citation/29546470/Perioperative_outcomes_and_adverse_events_of_robotic_colorectal_resections_for_inflammatory_bowel_disease:_a_systematic_literature_review_ L2 - https://dx.doi.org/10.1007/s10151-018-1766-5 DB - PRIME DP - Unbound Medicine ER -