Robotic-assisted ileocolic resection for Crohn’s disease: outcomes from an early national experience
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Crohn’s disease is an incurable inflammatory disorder that can affect the entire gastrointestinal tract. While medical management is considered first-line treatment, approximately 70–90% of patients with Crohn’s disease will require at least one surgical intervention during the course of their lifetimes. Traditionally, abdominal surgery for Crohn’s disease has been performed via an open approach with an increasing adoption of minimally invasive techniques. The aim of this study was to evaluate and compare postoperative outcomes from an initial national experience with robotic-assisted ileocolic resection for Crohn’s disease. Patients who underwent elective ileocolic resection for Crohn’s disease by robotic-assisted or open approaches from 2011 to Q3 2015 were identified using ICD-9 codes from the Premier Healthcare Database. Propensity-score matching (1:1) was performed using age, gender, race, Charlson index score, and year of surgery to form comparable cohorts in order to compare the robotic-assisted and open groups. 3641 patients underwent elective ileocolic resection for Crohn’s disease during the study period (1910 [52.5%] open and 109 [3%] robotic-assisted). Post-matched comparison of cohorts (n = 108 per cohort) showed that robotic-assisted cases were longer by a mean of 60 min (p < 0.0001), had shorter length of hospital stay by a median of 2 days (p < 0.001) and a lower 30-day complication rate (24% vs. 38%; p = 0.039). This national database assessment of patients undergoing elective ileocolic resection for Crohn’s disease demonstrated that a robotic-assisted approach was associated with longer operative times, shorter length of hospital stay and lower 30-day complication rates compared to open approach.
KeywordsCrohn’s disease Ileocolic resection Robotic-assisted Minimally invasive surgery Inflammatory bowel disease
Intuitive Surgical, Inc. funded independent editorial support.
Compliance with ethical standards
All procedures performed in studies 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.
For this retrospective, national database study, formal consent is not required.
Conflict of interest
Elizabeth R. Raskin has received speaker honoraria from Intuitive Surgical. Madhu L. Gorrepati and Shilpa Mehendale are employees of Intuitive Surgical. Wolfgang B. Gaertner declares that he has no conflict of interest.
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