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Frailty using the Clinical Frailty Scale to predict short- and long-term adverse outcomes following emergency laparotomy: meta-analysis. 利用临床虚弱量表预测急诊开腹手术后短期和长期不良后果:荟萃分析。
IF 4.3 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae078
Brittany Park, Zena Alani, Edrick Sulistio, Ahmed W H Barazanchi, Jonathan Koea, Alain Vandal, Andrew G Hill, Andrew D MacCormick
{"title":"Frailty using the Clinical Frailty Scale to predict short- and long-term adverse outcomes following emergency laparotomy: meta-analysis.","authors":"Brittany Park, Zena Alani, Edrick Sulistio, Ahmed W H Barazanchi, Jonathan Koea, Alain Vandal, Andrew G Hill, Andrew D MacCormick","doi":"10.1093/bjsopen/zrae078","DOIUrl":"10.1093/bjsopen/zrae078","url":null,"abstract":"<p><strong>Background: </strong>Emergency laparotomy has high morbidity and mortality rates. Frailty assessment remains underutilized in this setting, in part due to time constraints and feasibility. The Clinical Frailty Scale has been identified as the most appropriate tool for frailty assessment in emergency laparotomy patients and is recommended for all older patients undergoing emergency laparotomy. The prognostic impact of measured frailty using the Clinical Frailty Scale on short- and long-term mortality and morbidity rates remains to be determined.</p><p><strong>Methods: </strong>Observational cohort studies were identified by systematically searching Medline, Embase, Scopus and CENTRAL databases up to February 2024, comparing outcomes following emergency laparotomy for frail and non-frail participants defined according to the Clinical Frailty Scale. The primary outcomes were short- and long-term mortality rates. A random-effects model was created with pooling of effect estimates and a separate narrative synthesis was created. Risk of bias was assessed.</p><p><strong>Results: </strong>Twelve articles comprising 5704 patients were included. Frailty prevalence was 25% in all patients and 32% in older adults (age ≥55 years). Older patients with frailty had a significantly greater risk of postoperative death (30-day mortality rate OR 3.84, 95% c.i. 2.90 to 5.09, 1-year mortality rate OR 3.03, 95% c.i. 2.17 to 4.23). Meta-regression revealed that variations in cut-off values to define frailty did not significantly affect the association with frailty and 30-day mortality rate. Frailty was associated with higher rates of major complications (OR 1.93, 95% c.i. 1.27 to 2.93) and discharge to an increased level of care.</p><p><strong>Conclusion: </strong>Frailty is significantly correlated with short- and long-term mortality rates following emergency laparotomy, as well as an adverse morbidity rate and functional outcomes. Identifying frailty using the Clinical Frailty Scale may aid in patient-centred decision-making and implementation of tailored care strategies for these 'high-risk' patients, with the aim of reducing adverse outcomes following emergency laparotomy.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11336663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetic versus conventional stent in ureteral stenting: meta-analysis. 输尿管支架植入术中的磁性支架与传统支架:荟萃分析。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae086
Zhunan Xu, Hang Zhou, Qihua Wang, Congzhe Ren, Yang Pan, Shangren Wang, Li Liu, Xiaoqiang Liu
{"title":"Magnetic versus conventional stent in ureteral stenting: meta-analysis.","authors":"Zhunan Xu, Hang Zhou, Qihua Wang, Congzhe Ren, Yang Pan, Shangren Wang, Li Liu, Xiaoqiang Liu","doi":"10.1093/bjsopen/zrae086","DOIUrl":"10.1093/bjsopen/zrae086","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prophylactic negative pressure wound therapy (NPWT) in laparotomy wounds (PROPEL-2): protocol for a randomized clinical trial. 开腹手术伤口预防性负压疗法(NPWT)(PROPEL-2):随机临床试验方案。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae081
Matthew G Davey, Noel E Donlon, Stewart R Walsh, Claire L Donohoe
{"title":"Prophylactic negative pressure wound therapy (NPWT) in laparotomy wounds (PROPEL-2): protocol for a randomized clinical trial.","authors":"Matthew G Davey, Noel E Donlon, Stewart R Walsh, Claire L Donohoe","doi":"10.1093/bjsopen/zrae081","DOIUrl":"10.1093/bjsopen/zrae081","url":null,"abstract":"<p><strong>Background: </strong>A proportion of patients undergoing midline laparotomy will develop surgical site infections after surgery. These complications place considerable financial burden on healthcare economies and have negative implications for patient health and quality of life. The prophylactic application of negative pressure wound therapy devices has been mooted as a pragmatic strategy to reduce surgical site infections. Nevertheless, further availability of multicentre randomized clinical trial data evaluating the prophylactic use of negative pressure wound therapy following midline laparotomy is warranted to definitely provide consensus in relation to these closure methods, while also deciphering potential differences among subgroups. The aim of this study is to determine whether prophylactic negative pressure wound therapy reduces postoperative wound complications in patients undergoing midline laparotomy.</p><p><strong>Methods: </strong>PROPEL-2 is a multicentre prospective randomized clinical trial designed to compare standard surgical dressings (control arm) with negative pressure wound therapy dressings (Prevena™ and PICO™ being the most commonly utilized). Patient recruitment will include adult patients aged 18 years or over, who are indicated to undergo emergency or elective laparotomy. To achieve 90% power at the 5% significance level, 1006 patients will be required in each arm, which when allowing for losses to follow-up, 10% will be added to each arm, leaving the total projected sample size to be 2013 patients, who will be recruited across a 36-month enrolment period.</p><p><strong>Conclusion: </strong>The PROPEL-2 trial will be the largest independent multicentre randomized clinical trial designed to assess the role of prophylactic negative pressure wound therapy in patients indicated to undergo midline laparotomy. The comparison of standard treatment to two commercially available negative pressure wound therapy devices will help provide consensus on the routine management of laparotomy wounds. Enrolment to PROPEL-2 began in June 2023. Registration number: NCT05977816 (http://www.clinicaltrials.gov).</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11342967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142043858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
BJS and BJS Open correspondence to move to the BJS Academy. 北京和睦家医院和北京和睦家医院开放函授转入北京和睦家医院学院。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae077
Ville Sallinen, Desmond C Winter, Jonothan J Earnshaw
{"title":"BJS and BJS Open correspondence to move to the BJS Academy.","authors":"Ville Sallinen, Desmond C Winter, Jonothan J Earnshaw","doi":"10.1093/bjsopen/zrae077","DOIUrl":"10.1093/bjsopen/zrae077","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141490796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of resilience and psychological flexibility with surgeons' mental wellbeing. 复原力和心理灵活性与外科医生心理健康的关系。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae060
Maddy Greville-Harris, Catherine Withers, Agata Wezyk, Kevin Thomas, Helen Bolderston, Amy Kane, Sine McDougall, Kevin J Turner
{"title":"Association of resilience and psychological flexibility with surgeons' mental wellbeing.","authors":"Maddy Greville-Harris, Catherine Withers, Agata Wezyk, Kevin Thomas, Helen Bolderston, Amy Kane, Sine McDougall, Kevin J Turner","doi":"10.1093/bjsopen/zrae060","DOIUrl":"10.1093/bjsopen/zrae060","url":null,"abstract":"<p><strong>Background: </strong>Existing research highlights the link between certain personality traits and mental health in surgeons. However, little research has explored the important role of psychological skills and qualities in potentially explaining this link. A cross-sectional survey of UK-based surgeons was used to examine whether two such skills (psychological flexibility and resilience) helped to explain why certain personality traits might be linked to mental health in surgeons.</p><p><strong>Method: </strong>An online survey comprising measures of personality (neuroticism, extraversion and conscientiousness), psychological skills/qualities (psychological flexibility and resilience) and mental health (depression, anxiety, stress and burnout) was sent to surgeons practising in the UK. Mediation analyses were used to examine the potential mediating role of psychological flexibility and resilience in explaining the relationship between personality factors and mental health.</p><p><strong>Results: </strong>A total of 348 surgeons completed the survey. In all 12 mediation models, psychological flexibility and/or resilience played a significant role in explaining the relationship between personality traits (neuroticism, extraversion and conscientiousness) and mental health (depression, anxiety and burnout).</p><p><strong>Conclusion: </strong>Findings suggest that it is not only a surgeon's personality that is associated with their mental health, but the extent to which a surgeon demonstrates specific psychological qualities and skills (psychological flexibility and resilience). This has important implications for improving surgeons' mental wellbeing, because psychological flexibility and resilience are malleable, and can be successfully targeted with interventions in a way that personality traits cannot.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Supporting a diverse surgeon workforce: embracing personality and supporting psychological resilience to improve surgeon health and wellbeing. 支持多样化的外科医生队伍:接纳个性并支持心理复原力,以改善外科医生的健康和福祉。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae072
Tasha M Hughes, Carrie E Cunningham
{"title":"Supporting a diverse surgeon workforce: embracing personality and supporting psychological resilience to improve surgeon health and wellbeing.","authors":"Tasha M Hughes, Carrie E Cunningham","doi":"10.1093/bjsopen/zrae072","DOIUrl":"10.1093/bjsopen/zrae072","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evolution and improved outcomes in the era of multimodality treatment for extended pancreatectomy. 扩展胰腺切除术多模式治疗时代的演变和更好的疗效。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae065
Vikram A Chaudhari, Aditya R Kunte, Amit N Chopde, Vikas Ostwal, Anant Ramaswamy, Reena Engineer, Prabhat Bhargava, Munita Bal, Nitin Shetty, Suyash Kulkarni, Shraddha Patkar, Manish S Bhandare, Shailesh V Shrikhande
{"title":"Evolution and improved outcomes in the era of multimodality treatment for extended pancreatectomy.","authors":"Vikram A Chaudhari, Aditya R Kunte, Amit N Chopde, Vikas Ostwal, Anant Ramaswamy, Reena Engineer, Prabhat Bhargava, Munita Bal, Nitin Shetty, Suyash Kulkarni, Shraddha Patkar, Manish S Bhandare, Shailesh V Shrikhande","doi":"10.1093/bjsopen/zrae065","DOIUrl":"10.1093/bjsopen/zrae065","url":null,"abstract":"<p><strong>Background: </strong>The evolution and outcomes of extended pancreatectomies at a single institute over 15 years are presented in this study.</p><p><strong>Methods: </strong>A retrospective analysis of the institutional database was performed from 2015 to 2022 (period B). Patients undergoing extended pancreatic resections, as defined by the International Study Group for Pancreatic Surgery, were included. Perioperative and survival outcomes were compared with data from 2007-2015 (period A). Regression analyses were used to identify factors affecting postoperative and long-term survival outcomes.</p><p><strong>Results: </strong>A total of 197 (16.1%) patients underwent an extended resection in period B compared to 63 (9.2%) in period A. Higher proportions of borderline resectable (5 (18.5%) versus 51 (47.7%), P = 0.011) and locally advanced tumours (1 (3.7%) versus 24 (22.4%), P < 0.001) were resected in period B with more frequent use of neoadjuvant therapy (6 (22.2%) versus 79 (73.8%), P < 0.001). Perioperative mortality (4 (6.0%) versus 12 (6.1%), P = 0.81) and morbidity (23 (36.5%) versus 83 (42.1%), P = 0.57) rates were comparable. The overall survival for patients with pancreatic adenocarcinoma was similar in both periods (17.5 (95% c.i. 6.77 to 28.22) versus 18.3 (95% c.i. 7.91 to 28.68) months, P = 0.958). Resectable, node-positive tumours had a longer disease-free survival (DFS) in period B (5.81 (95% c.i. 1.73 to 9.89) versus 14.03 (95% c.i. 5.7 to 22.35) months, P = 0.018).</p><p><strong>Conclusion: </strong>Increasingly complex pancreatic resections were performed with consistent perioperative outcomes and improved DFS compared to the earlier period. A graduated approach to escalating surgical complexity, multimodality treatment, and judicious patient selection enables the resection of advanced pancreatic tumours.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11293468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Total mesorectal excision quality in rectal cancer surgery affects local recurrence rate but not distant recurrence and survival: population-based cohort study. 直肠癌手术的全直肠系膜切除质量影响局部复发率,但不影响远处复发和生存:基于人群的队列研究。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae071
Åsa Collin, Cecilia Dahlbäck, Joakim Folkesson, Pamela Buchwald
{"title":"Total mesorectal excision quality in rectal cancer surgery affects local recurrence rate but not distant recurrence and survival: population-based cohort study.","authors":"Åsa Collin, Cecilia Dahlbäck, Joakim Folkesson, Pamela Buchwald","doi":"10.1093/bjsopen/zrae071","DOIUrl":"10.1093/bjsopen/zrae071","url":null,"abstract":"<p><strong>Background: </strong>The quality of the total mesorectal excision specimen in rectal cancer surgery is assessed with a three-tier grade (mesorectal, intramesorectal and muscularis propria). This study aimed to analyse the prognostic impact of the total mesorectal excision grade on survival, and to identify risk factors for intramesorectal and muscularis propria resection in a population-based setting.</p><p><strong>Methods: </strong>All patients in the Swedish Colorectal Cancer Registry with rectal cancer stage I-III ≤ 10 cm from the anal verge, diagnosed 2015-2019, undergoing total mesorectal excision were analysed. Clinical, surgical and pathological data were retrieved and analysed for the following primary outcomes: local and distant recurrence and overall and relative survival; secondary outcomes were risk factors for total mesorectal excision grading (intramesorectal or muscularis propria resection). Of note, postoperative death < 30 days or recurrence within 90 days were exclusion criteria for survival and recurrence analysis. Recurrence-free patients with less than 3 years follow-up, and patients lacking data regarding recurrence, were also excluded from recurrence analyses.</p><p><strong>Results: </strong>Overall, of 7979 patients treated during the study interval, 1499 patients were eligible for recurrence, 2441 patients for survival and 2476 patients for risk-factor analyses, of which 75% were graded mesorectal, 17% intramesorectal and 8% muscularis propria. Median follow-up for survival was 42 (1-77) months. The worst total mesorectal excision grading (muscularis propria resection) was an independent risk factor for local recurrence in multivariable analysis (HR 2.73, 95% c.i. 1.07 to 7.0, P = 0.036). Total mesorectal excision grade had no impact on distant recurrence or survival. Female sex, tumour level <5 cm, abdominoperineal resection, minimally invasive surgery (laparoscopic and robotic), high blood loss, long duration of surgery and intraoperative perforation were independent risk factors for worse total mesorectal excision grading (intramesorectal and/or muscularis propria resection) in multivariable analyses.</p><p><strong>Conclusion: </strong>Muscularis propria resection increases the risk of local recurrence but does not seem to affect distant recurrence or survival.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prospective nationwide analysis of long-term recurrence rates after elective ventral, incisional and parastomal hernia repairs. 对选择性腹股沟疝、切口疝和腹膜旁疝修补术后长期复发率的全国性前瞻性分析。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae070
Nadia A Henriksen, Frederik Helgstrand
{"title":"Prospective nationwide analysis of long-term recurrence rates after elective ventral, incisional and parastomal hernia repairs.","authors":"Nadia A Henriksen, Frederik Helgstrand","doi":"10.1093/bjsopen/zrae070","DOIUrl":"10.1093/bjsopen/zrae070","url":null,"abstract":"","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Robot-assisted minimally invasive oesophagectomy versus thoracoscopic approach: multi-institutional study on short-term outcomes. 机器人辅助微创食管切除术与胸腔镜方法:多机构短期疗效研究。
IF 3.5 3区 医学
BJS Open Pub Date : 2024-07-02 DOI: 10.1093/bjsopen/zrae063
Yin-Kai Chao, Jui-Ying Lee, Wen-Chien Huang, Jang-Ming Lee, Yau-Lin Tseng, Hung-I Lu
{"title":"Robot-assisted minimally invasive oesophagectomy versus thoracoscopic approach: multi-institutional study on short-term outcomes.","authors":"Yin-Kai Chao, Jui-Ying Lee, Wen-Chien Huang, Jang-Ming Lee, Yau-Lin Tseng, Hung-I Lu","doi":"10.1093/bjsopen/zrae063","DOIUrl":"10.1093/bjsopen/zrae063","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted minimally invasive oesophagectomy and conventional minimally invasive oesophagectomy are superior to open techniques. However, few studies have directly compared the outcomes of the two minimally invasive approaches.</p><p><strong>Methods: </strong>A retrospective study of patients from six medical centres with oesophageal squamous cell carcinoma who underwent minimally invasive oesophagectomy between 2015 and 2022. Perioperative outcomes were compared after applying inverse probability of treatment weighting.</p><p><strong>Results: </strong>The study included 577 patients (robot-assisted minimally invasive oesophagectomy: 206; conventional minimally invasive oesophagectomy: 371). After applying inverse probability of treatment weighting, robot-assisted minimally invasive oesophagectomy was found to yield a higher number of mediastinal nodes compared with conventional minimally invasive oesophagectomy (14.86 versus 12.66, P = 0.017). Robot-assisted minimally invasive oesophagectomy was notably effective in retrieving upper mediastinal left recurrent laryngeal nerve nodes, averaging 1.97 nodes versus 1.14 nodes harvested by conventional minimally invasive oesophagectomy (P < 0.001). This was coupled by a significant decrease in nerve palsy rates (13.9% versus 22.8%, P = 0.020). A significantly larger percentage of patients in the robot-assisted minimally invasive oesophagectomy group had an uncomplicated postoperative course (51.8% versus 34%, P < 0.001). Robot-assisted minimally invasive oesophagectomy also led to a reduction in pneumonia rates (8.6% versus 15.2%, P = 0.041) and was linked to a shorter length of stay (length of stay; 16.64 versus 21.14 days, P = 0.007). The advantage of robot-assisted minimally invasive oesophagectomy in reducing the length of stay was especially pronounced in patients with a high Charlson co-morbidity index (≥2, mean difference 8.46 days; P = 0.0069) and those who underwent neoadjuvant therapy (mean difference 5.63 days; P < 0.001).</p><p><strong>Conclusion: </strong>In oesophageal squamous cell carcinoma, the use of robot-assisted minimally invasive oesophagectomy led to fewer cases of pneumonia and faster recovery compared with conventional minimally invasive oesophagectomy. Additionally, robot-assisted minimally invasive oesophagectomy significantly improved the feasibility and safety of performing lymph node dissection along the recurrent laryngeal nerve.</p>","PeriodicalId":9028,"journal":{"name":"BJS Open","volume":"8 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11264138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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