开放、腹腔镜和机器人辅助手术中的输血风险:一项跨外科学科的倾向评分匹配病例-对照研究。

IF 1.9 4区 医学 Q3 HEMATOLOGY
Transfusion Medicine and Hemotherapy Pub Date : 2024-10-21 eCollection Date: 2025-04-01 DOI:10.1159/000540981
Florian Rumpf, Suma Choorapoikayil, Lotta Hof, Keyan Salari, Olaf Baumhove, Alexandra Bayer, Patrick Friederich, Jens Friedrich, Gunnar Elke, Matthias Gruenewald, Diana Narita, Ansgar Raadts, Klaus Schwendner, Dana J Jenke, Andrea U Steinbicker, Josef Thoma, Viola Weber, Markus Velten, Maria Wittmann, Henry Weigt, Björn Lange, Kai Zacharowski, Patrick Meybohm
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引用次数: 0

摘要

与传统手术相比,机器人辅助手术越来越多地应用于各种外科学科,显示出更好的肿瘤和功能结果。目的:尚不清楚机器人辅助手术如何影响围手术期贫血和对血液制品的需求。方法:在这项病例对照研究中,15,009对接受泌尿外科、内脏外科或胸外科手术的匹配患者被纳入研究。采用倾向评分匹配对机器人辅助手术、腹腔镜手术和开放手术进行两两比较。结果:与开放手术相比,机器人辅助手术与异基因红细胞输血风险降低相关,RR: 0.32 (95% CI: 0.27-0.37),围手术期血红蛋白降低有限(围手术期血红蛋白差异为0.40 g/dL, 95% CI: 0.31-0.49)。机器人辅助手术与住院时间缩短4.29天相关(95% CI: 3.74-4.84)。与腹腔镜手术相比,机器人辅助手术对红细胞输注(RR: 0.94, 95% CI: 0.75-1.18)、围手术期血红蛋白(0.27 g/dL, 95% CI: 0.16-0.38)或住院时间0.53天(95% CI: -0.14-1.19)无显著影响。结论:与开放手术相比,机器人辅助和腹腔镜手术可以减少输血,因此微创手术的发展是改善患者预后的重要措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transfusion Risk in Open, Laparoscopic, and Robotic-Assisted Surgery: A Propensity Score Matched Case-Control Study across Surgical Disciplines.

Introduction: Robotic-assisted surgery is increasingly performed in various surgical disciplines demonstrating improved oncological and functional outcomes compared to conventional surgery.

Objective: Unclear is how robotic-assisted surgery affects perioperative anemia and the need for blood products.

Methods: In this case-control study, 15,009 matched patient pairs undergoing urological, visceral, or thoracic surgery were included. Pairwise comparisons between robotic-assisted surgery, laparoscopic surgery, and open surgery were performed with propensity score matching.

Results: Robotic-assisted surgery compared to open surgery was associated with a risk reduction of allogeneic red blood cell transfusion by RR: 0.32 (95% CI: 0.27-0.37) and a limited reduction of perioperative hemoglobin (perioperative hemoglobin difference of 0.40 g/dL, 95% CI: 0.31-0.49). Robotic-assisted surgery was associated with a shorter length of hospital stay by 4.29 days (95% CI: 3.74-4.84). Compared to laparoscopic surgery, robotic-assisted surgery had no significant effect on red blood cell transfusions (RR: 0.94, 95% CI: 0.75-1.18), perioperative hemoglobin (0.27 g/dL, 95% CI: 0.16-0.38), or length of hospital stay 0.53 days (95% CI: -0.14-1.19).

Conclusions: Robotic-assisted and laparoscopic procedures are associated with reduced blood transfusions compared to open surgery and, thus the advancement of minimally invasive procedures constitutes an important measure to improve patient outcomes.

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来源期刊
CiteScore
4.00
自引率
9.10%
发文量
47
审稿时长
6-12 weeks
期刊介绍: This journal is devoted to all areas of transfusion medicine. These include the quality and security of blood products, therapy with blood components and plasma derivatives, transfusion-related questions in transplantation, stem cell manipulation, therapeutic and diagnostic problems of homeostasis, immuno-hematological investigations, and legal aspects of the production of blood products as well as hemotherapy. Both comprehensive reviews and primary publications that detail the newest work in transfusion medicine and hemotherapy promote the international exchange of knowledge within these disciplines. Consistent with this goal, continuing clinical education is also specifically addressed.
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