Использование робота для желудочного шунтирования
Obes Surg. 2015 Sep 19. [Epub ahead of print]
Robotic Roux-en-Y Gastric Bypass, is it Safer than Laparoscopic Bypass?
Moon RC1, Gutierrez JC1, Royall NA1, Teixeira AF1, Jawad MA2.
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Abstract
BACKGROUND:
Along with the development of technology, robotic approach is being performed for laparoscopic Roux-en-Y gastric bypass (LRYGB). Some literatures reported same or better peri-operative outcomes with the robotic procedure. The aim of this study is to compare our experience in robot-assisted LRYGB (RA-LRYGB) with LRYGB in terms of peri-operative outcomes.
METHODS:
From January 1, 2012 to April 30, 2014, a total of 270 patients underwent LRYGB by one surgeon at a single institution. Of these, 64 cases were done robotically. A retrospective review was performed for these patients, noting the outcomes and complications of the procedure.
RESULTS:
The 64 RA-LRYGB patients had a mean age of 45.9 ± 10.0 years (range, 23-67) and a mean preoperative body mass index (BMI) of 48.4 ± 7.9 kg/m2 (range, 33.8-76.4). The 207 LRYGB patients had a mean age of 45.0 ± 10.7 years (range, 21-67) and a mean preoperative BMI of 48.4 ± 8.1 kg/m2 (range, 34.0-80.4). These two groups were clinically comparable. Mean length of hospital stay was 3.0 ± 4.1 days (range, 1-19) in RA-LRYGB patients, significantly longer than 1.6 ± 1.7 days (range, 1-17) in LRYGB patients (p < 0.01). Thirty-day readmission rate was 9.3 % (n = 6) in the RA-LRYGB group and 6.8 % (n = 14) in the LRYGB group. Higher leak rate was noticed in RA-LRYGB patients at 7.8 % (n = 5), compared to 0.5 % (n = 1) in LRYGB patients (p < 0.01). All the leaks occurred at the pouch level in the RA-LRYGB group, while one leak from the LRYGB group occurred at the gastrojejunal anastomosis site.
CONCLUSIONS:
Robot-assisted Roux-en-Y gastric bypass may result in higher leak rate at the pouch level, when compared to that of laparoscopic procedures.
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