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Risk factors for postoperative complications in robotic general surgery

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Abstract

The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study. All consecutive robotic surgical procedures from November 2001 to December 2013 were included. One thousand consecutive general surgery patients met the inclusion criteria. The mean overall postoperative morbidity and major postoperative morbidity (Clavien >III) rates were 20.4 and 6 %, respectively. This included a conversion rate of 4.4 %, reoperation rate of 4.5 %, and mortality rate of 0.2 %. Multivariate analysis showed that ASA score >3 [OR 1.7; 95 % CI (1.2–2.4)], hematocrit value <38 [OR 1.6; 95 % CI (1.1–2.2)], previous abdominal surgery [OR 1.5; 95 % CI (1–2)], advanced dissection [OR 5.8; 95 % CI (3.1–10.6)], and multiquadrant surgery [OR 2.5; 95 % CI (1.7–3.8)] remained independent risk factors for overall postoperative morbidity. It also showed that advanced dissection [OR 4.4; 95 % CI (1.9–9.6)] and multiquadrant surgery [OR 4.4; 95 % CI (2.3–8.5)] remained independent risk factors for major postoperative morbidity (Clavien >III). This study identifies independent risk factors for postoperative overall and major morbidity in robotic general surgery. Because these factors independently impacted postoperative complications, we believe they could be taken into account in future studies comparing conventional versus robot-assisted laparoscopic procedures in general surgery.

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Author information

Authors and Affiliations

  1. Department of Digestive, Hepato-Biliary, Endocrine, and Surgical Oncology, CHU Nancy-Hospital Brabois Adultes, University de Lorraine, 11 allee du morvan, 54511, Vandoeuvre les Nancy, France

    Giovanni Fantola, Laurent Brunaud, Adeline Germain, Ahmet Ayav & Laurent Bresler

  2. Faculty de medicine, INSERM U954, University de Lorraine, Nancy, France

    Laurent Brunaud

  3. Clinical Epidemiology and Evaluation Department, INSERM, CIC-EC1433, CHU Nancy, Pôle S2R, University de Lorraine, 54000, Nancy, France

    Phi-Linh Nguyen-Thi

Authors
  1. Giovanni Fantola
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  2. Laurent Brunaud
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  3. Phi-Linh Nguyen-Thi
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  4. Adeline Germain
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  5. Ahmet Ayav
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  6. Laurent Bresler
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Corresponding author

Correspondence to Laurent Brunaud.

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Conflict of interest

The authors declare that they have no conflict of interest. L Bresler is a proctor for intuitive surgical (pelvic surgery).

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

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Formal consent is not required for retrospective study.

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Fantola, G., Brunaud, L., Nguyen-Thi, PL. et al. Risk factors for postoperative complications in robotic general surgery. Updates Surg 69, 45–54 (2017). https://doi.org/10.1007/s13304-016-0398-4

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  • DOI: https://doi.org/10.1007/s13304-016-0398-4

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