Robotic Versus Laparoscopic Hiatal Hernia Repair: A Statewide Analysis Using Severity-Graded Complication Outcomes.

IF 1.3 4区医学 Q3 SURGERY

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2026-09-28 DOI:10.1097/SLE.0000000000001511

Jorge Urbina, Carlos Galvani, Salvatore Docimo, Christopher DuCoin, Rana Pullatt, Nicholas Spurbeck, Benjamin Clapp

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引用次数: 0

Abstract

Background: Robotic-assisted hiatal hernia repair has increased substantially, but comparative outcomes relative to laparoscopy remain incompletely defined.

Methods: We performed a retrospective cohort study using the 2024 Texas Inpatient Public Use Data File. Adult patients undergoing minimally invasive hiatal hernia repair were identified using ICD-10-PCS codes and stratified by surgical approach and mesh use. The primary outcome was major complication (Clavien-Dindo ≥III proxy). Multivariable logistic regression adjusted for demographics, comorbidity burden, admission acuity, and clinical presentation.

Results: Among 3511 patients (1739 laparoscopic and 1772 robotic), major complications differed across groups, with the highest rates in robotic cases without mesh (14.4% vs. 9.3%, P=0.002). The robotic approach was associated with increased odds of major complications (aOR=1.28, 95% CI: 1.04-1.59, P=0.021), persisting in elective cases (aOR=1.38, P=0.013). No differences were observed in Clavien-Dindo ≥IV complications or mortality.

Conclusions: Robotic repair was associated with increased intervention-level complications, with no differences in severe complications or mortality.

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机器人与腹腔镜裂孔疝修补：一项使用严重程度分级并发症结果的全州分析。

背景：机器人辅助裂孔疝修补术已大大增加，但相对于腹腔镜的比较结果仍不完全明确。方法：我们使用2024年德克萨斯州住院病人公共使用数据文件进行了回顾性队列研究。采用ICD-10-PCS编码对接受微创裂孔疝修补术的成年患者进行识别，并根据手术入路和补片的使用进行分层。主要结局为主要并发症（Clavien-Dindo≥III代理）。多变量logistic回归校正了人口统计学、合并症负担、入院敏锐度和临床表现。结果：3511例患者（1739例腹腔镜手术，1772例机器人手术）中，主要并发症在不同组间存在差异，无补片的机器人手术发生率最高（14.4%比9.3%，P=0.002）。机器人入路与主要并发症的发生率增加相关（aOR=1.28, 95% CI: 1.04-1.59， P=0.021），在选择性病例中持续存在（aOR=1.38， P=0.013）。Clavien-Dindo≥IV并发症或死亡率无差异。结论：机器人修复与干预级并发症的增加有关，在严重并发症或死亡率方面没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.