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
{"title":"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。","authors":"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","doi":"10.1159/000540981","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-assisted surgery is increasingly performed in various surgical disciplines demonstrating improved oncological and functional outcomes compared to conventional surgery.</p><p><strong>Objective: </strong>Unclear is how robotic-assisted surgery affects perioperative anemia and the need for blood products.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23252,"journal":{"name":"Transfusion Medicine and Hemotherapy","volume":"52 2","pages":"142-151"},"PeriodicalIF":1.9000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975338/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transfusion Risk in Open, Laparoscopic, and Robotic-Assisted Surgery: A Propensity Score Matched Case-Control Study across Surgical Disciplines.\",\"authors\":\"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\",\"doi\":\"10.1159/000540981\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Robotic-assisted surgery is increasingly performed in various surgical disciplines demonstrating improved oncological and functional outcomes compared to conventional surgery.</p><p><strong>Objective: </strong>Unclear is how robotic-assisted surgery affects perioperative anemia and the need for blood products.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":23252,\"journal\":{\"name\":\"Transfusion Medicine and Hemotherapy\",\"volume\":\"52 2\",\"pages\":\"142-151\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975338/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transfusion Medicine and Hemotherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000540981\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transfusion Medicine and Hemotherapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000540981","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
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.
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.