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A retrospective comparison of 90-day outcomes, length of stay, and readmissions between robotic-assisted and laparoscopic colectomy

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Abstract

Investigations generally assess 30 days of perioperative outcomes with robotic-assisted and laparoscopic colectomy. Outcomes beyond 30 days serve as a quality metric of surgical services and an assessment of 90 days of outcomes may have greater clinical utility. The purpose of this study was to assess 90 days of outcomes, length of stay (LOS), and readmissions among patients who underwent a robotic-assisted versus laparoscopic colectomy using a national database. Patients undergoing either robotic-assisted or laparoscopic colectomy were identified using Current Procedural Terminology (CPT) codes within PearlDiver, a national, inpatient records database from 2010 to 2019. Outcomes were defined using the National Surgical Quality Improvement Program (NSQIP) risk calculator and identified using International Classification of Disease (ICD) diagnosis codes. Categorical variables were compared using chi-square tests, and continuous variables were compared using paired t tests. Covariate-adjusted regression models were also constructed to evaluate these associations while accounting for potential confounders. A total of 82,495 patients were assessed in this study. At 90 days, patients of the laparoscopic colectomy cohort experienced a higher rate of complications than patients who underwent robotic-assisted colectomy (9.5 vs. 6.6%, p < 0.001). There were no significant differences in LOS (6 vs. 6.5 days, p = 0.08) and readmissions (6.1 vs. 6.7%, p = 0.851) at 90 days. Patients undergoing robotic-assisted colectomy have a lower risk for morbidity at 90 days. Neither approach is superior for LOS nor 90 days of readmissions. Both techniques are effective minimally invasive procedures, yet patients may gain a greater risk benefit from robotic colectomy.

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References

  1. Sheetz KH, Claflin J, Dimick JB (2020) Trends in the adoption of robotic surgery for common surgical procedures. JAMA Netw Open 3(1):e1918911

    Article  PubMed  PubMed Central  Google Scholar 

  2. Solaini L, Bazzocchi F, Cavaliere D, Avanzolini A, Cucchetti A, Ercolani G (2018) Robotic versus laparoscopic right colectomy: an updated systematic review and meta-analysis. Surg Endosc 32(3):1104–1110

    Article  PubMed  Google Scholar 

  3. Giordano L, Kassir AA, Gamagami RA, Lujan HJ, Plasencia G, Santiago C (2020) Robotic-assisted and laparoscopic sigmoid resection. JSLS. https://doi.org/10.4293/JSLS.2020.00028

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bilgin IA, Bas M, Benlice C, Esen E, Ozben V, Aytac E et al (2020) Totally laparoscopic and totally robotic surgery in patients with left-sided colonic diverticulitis. Int J Med Robot 16(1):e2068

    Article  PubMed  Google Scholar 

  5. McCarthy E, Gough BL, Johns MS, Hanlon A, Vaid S, Petrelli N (2020) A comparison of colectomy outcomes utilizing open, laparoscopic, and robotic techniques. Am Surg. https://doi.org/10.1177/0003134820973384

    Article  PubMed  Google Scholar 

  6. Ackerman SJ, Daniel S, Baik R, Liu E, Mehendale S, Tackett S, Hellan M (2018) Comparison of complication and conversion rates between robotic-assisted and laparoscopic rectal resection for rectal cancer: which patients and providers could benefit most from robotic-assisted surgery? J Med Econ 21(3):254–261. https://doi.org/10.1080/13696998.2017.1396994. (Epub 2017 Nov 14 PMID: 29065737)

    Article  PubMed  Google Scholar 

  7. Trastulli S, Cirocchi R, Desiderio J, Coratti A, Guarino S, Renzi C, Corsi A, Boselli C, Santoro A, Minelli L, Parisi A (2015) Robotic versus laparoscopic approach in colonic resections for cancer and benign diseases: systematic review and meta-analysis. PLoS ONE 10(7):e0134062. https://doi.org/10.1371/journal.pone.0134062. (PMID: 26214845; PMCID: PMC4516360)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Pigazzi A, Stamos MJ, Mills S (2016) Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy. Surg Endosc 30(7):2792–2798. https://doi.org/10.1007/s00464-015-4552-8. (Epub 2015 Oct 20 PMID: 26487196)

    Article  PubMed  Google Scholar 

  9. Waters PS, Cheung FP, Peacock O, Heriot AG, Warrier SK, O’Riordain DS, Pillinger S, Lynch AC, Stevenson ARL (2020) Successful patient-oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer—a systematic review. Colorectal Dis 22(5):488–499. https://doi.org/10.1111/codi.14822. (Epub 2019 Sep 4 PMID: 31400185)

    Article  CAS  PubMed  Google Scholar 

  10. Al-Temimi MH, Chandrasekaran B, Agapian J, Peters WR Jr, Wells KO (2019) Robotic versus laparoscopic elective colectomy for left side diverticulitis: a propensity score-matched analysis of the NSQIP database. Int J Colorectal Dis 34(8):1385–1392

    Article  PubMed  Google Scholar 

  11. Tagliabue F, Burati M, Chiarelli M, Fumagalli L, Guttadauro A, Arborio E et al (2020) Robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: an observational study. World J Gastrointest Surg 12(6):287–297

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bhama AR, Obias V, Welch KB, Vanderwarker JF, Clearly RK (2016) A comparison of laparoscopic and roboitic colorectal surgery outcomes using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Surg Endosc 30:1576–1584

    Article  PubMed  Google Scholar 

  13. Miller PE, Dao H, Paluvoi N, Bailey M, Margolin D, Shah N, Vargas HD (2016) Comparison of 30-day postoperative outcomes after laparoscopic vs robotic colectomy. J Am Coll Surg 223(2):369–373. https://doi.org/10.1016/j.jamcollsurg.2016.03.041. (Epub 2016 Apr 19 PMID: 27109780)

    Article  PubMed  Google Scholar 

  14. Kulaylat AS, Mirkin KA, Puleo FJ, Hollenbeak CS, Messaris E (2018) Robotic versus standard laparoscopic elective colectomy: where are the benefits? J Surg Res 224:72–78. https://doi.org/10.1016/j.jss.2017.11.059. (Epub 2017 Dec 22 PMID: 29506855)

    Article  PubMed  Google Scholar 

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Funding

The authors declare that no funds, grants, or other support was received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Sahir S. Pervaiz

  2. Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Christopher D’Adamo

  3. Department of Surgery, Sinai Hospital, Baltimore, MD, USA

    Arun Mavanur & Joshua H. Wolf

  4. Department of Surgery, Georgetown University, Washington, DC, USA

    Arun Mavanur & Joshua H. Wolf

  5. Department of Surgery, Johns Hopkins University, Baltimore, MD, USA

    Arun Mavanur

Authors
  1. Sahir S. Pervaiz
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  2. Christopher D’Adamo
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  3. Arun Mavanur
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  4. Joshua H. Wolf
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all the authors listed. The first draft of the manuscript was written by SP and JW, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Joshua H. Wolf.

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Pervaiz, S.S., D’Adamo, C., Mavanur, A. et al. A retrospective comparison of 90-day outcomes, length of stay, and readmissions between robotic-assisted and laparoscopic colectomy. J Robotic Surg 17, 2205–2209 (2023). https://doi.org/10.1007/s11701-023-01642-7

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  • DOI: https://doi.org/10.1007/s11701-023-01642-7

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