Comparative surgical outcomes of single port SP1098 vs multiport Xi platforms for benign hysterectomy using the validated comprehensive complication index.

IF 3 3区 医学 Q2 SURGERY
Evrim Erdemoglu, Francesca I Galasso, Jamal Mourad, Kristina Butler, Javier Magrina, Johnny Yi
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引用次数: 0

Abstract

Background: There is limited published data evaluating the safety of the da-Vinci-SP1098 platform and only a few utilize the Clavien-Dindo Classification (CDC). Comprehensive complication index (CCI) is developed to overcome the restrictions of the CDC. We aimed to compare the perioperative outcomes of hysterectomy for benign disease with the da-Vinci-SP1098 platform (SPORT-SP-H) with the multiport-XI-hysterectomy (MP-Xi-H).

Methods: We conducted a retrospective cohort study incorporating a total of 96 patients at a tertiary academic center. Parameters included demographic features, Charlson comorbidity index, Surgical APGAR, indications, and concurrent procedures. Perioperative outcomes included CCI score, CDC grade, length of operation, estimated blood loss, intraoperative complications, length of stay, and conversion rate, sequelae, failure to cure, reoperation and emergency department visit within 1 month. Univariate and multivariate analysis for CCI, CDC and operation duration was undertaken.

Results: Demographic factors were similar. Charlson's comorbidity index (B = 1.43, 95% CI 0.17-2.6, p = 0.02) was found to be the only independent predictor of CCI in the multivariate analysis. There were no grade IV or higher CDC postoperative complications. Except CDC grade I, all were similar between the cohorts. Operation time was significantly longer in SPORT-SP-H (178, r 85-258) compared to MP-Xi-H (123.5, r 74-218, p < 0.0001). Length of hospital stay and other parameters were comparable between the groups (p > 0.05). Independent predictors of longer operation time were SPORT-SP-H, uterine weight and concurrent procedures.

Conclusions: SPORT-SP-Hysterectomy (SP1098) appears to be an alternative to multiport robotic hysterectomy but with a longer operating time. Morbidity is related to surgical complexity and patient comorbidities rather than the robotic platform.

采用经验证的综合并发症指数比较单孔SP1098与多孔Xi平台良性子宫切除术的手术效果
背景:评价da-Vinci-SP1098平台安全性的已发表数据有限,只有少数使用Clavien-Dindo分类(CDC)。综合并发症指数(CCI)是为了克服疾病控制中心的局限性而开发的。我们的目的是比较da-Vinci-SP1098平台(SPORT-SP-H)和multi - port- xi -子宫切除术(MP-Xi-H)的良性疾病子宫切除术的围手术期结果。方法:我们在一个三级学术中心进行了一项回顾性队列研究,共纳入96例患者。参数包括人口统计学特征、Charlson合并症指数、外科APGAR、适应症和并发手术。围手术期结果包括CCI评分、CDC分级、手术时间、估计出血量、术中并发症、住院时间、转换率、后遗症、治愈失败、再手术及1个月内急诊科就诊情况。对CCI、CDC和手术时间进行单因素和多因素分析。结果:人口学因素相似。在多变量分析中,Charlson合并症指数(B = 1.43, 95% CI 0.17-2.6, p = 0.02)是CCI的唯一独立预测因子。无四级及以上CDC术后并发症。除CDC分级I外,各队列间均相似。手术时间SPORT-SP-H组(178,r 85 ~ 258)明显长于MP-Xi-H组(123.5,r 74 ~ 218, p 0.05)。SPORT-SP-H、子宫重量和同期手术是延长手术时间的独立预测因素。结论:sport - sp -子宫切除术(SP1098)是多端口机器人子宫切除术的替代方案,但手术时间较长。发病率与手术复杂性和患者合并症有关,而与机器人平台无关。
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来源期刊
CiteScore
4.20
自引率
8.70%
发文量
145
期刊介绍: The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.
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