{"title":"肥胖患者的机器人与腹腔镜腹股沟疝修复的住院结果：2005-2020年全国住院患者样本分析","authors":"Hung-Jia Pai, Ching-Chuan Hsieh","doi":"10.1007/s10029-025-03313-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is associated with complications in surgical procedures and postoperative outcomes. This study aims to compare in-hospital outcomes of robotic inguinal hernia repair (RIHR) and laparoscopic inguinal hernia repair (LIHR) in obese patients.</p><p><strong>Methods: </strong>Data from the National Inpatient Sample (NIS) from 2005 to 2020 were used in this study. Inclusion criteria were ≥ 18 years old with obesity (body mass index ≥ 30 kg/m²) who underwent either RIHR or LIHR. Data were analyzed for in-hospital mortality, length of stay (LOS), total hospital costs, and complications.</p><p><strong>Results: </strong>A total of 647 patients were included. Multivariable analysis showed RIHR was associated with a significantly lower risk of any complications (adjusted odds ratio [aOR] = 0.53, 95% confidence interval [CI]: 0.36, 0.77), shorter LOS (adjusted Beta [aBeta] = -0.94, 95%CI: -1.02, -0.86), and higher total hospital costs (aBeta = 5.62, 95%CI: 4.80, 6.44). Stratified analysis revealed that the lower risk of complications with RIHR was consistent across most subgroups, including age < 60 years (aOR = 0.56) and ≥ 60 years (aOR = 0.53), non-smokers (aOR = 0.53) and smokers (aOR = 0.48), non-hypertensive (aOR = 0.27) and hypertensive patients (aOR = 0.66), and non-diabetic (aOR = 0.53) and diabetic patients (aOR = 0.44), as well as patients admitted during 2017-2020 (aOR = 0.50).</p><p><strong>Conclusions: </strong>RIHR is associated with lower complication risk and shorter LOS, but higher hospital costs compared to LIHR for obese patients. These findings suggest that RIHR may offer better short-term outcomes for obese patients, which should be considered in surgical decision-making. Given the retrospective nature of this analysis and the potential for selection bias and residual confounding, future randomized controlled trials are warranted to confirm these findings and provide more robust evidence to guide surgical decision-making.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"122"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003516/pdf/","citationCount":"0","resultStr":"{\"title\":\"In-hospital outcomes of robotic versus laparoscopic inguinal hernia repair in obese patients: a national inpatient sample analysis 2005-2020.\",\"authors\":\"Hung-Jia Pai, Ching-Chuan Hsieh\",\"doi\":\"10.1007/s10029-025-03313-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Obesity is associated with complications in surgical procedures and postoperative outcomes. This study aims to compare in-hospital outcomes of robotic inguinal hernia repair (RIHR) and laparoscopic inguinal hernia repair (LIHR) in obese patients.</p><p><strong>Methods: </strong>Data from the National Inpatient Sample (NIS) from 2005 to 2020 were used in this study. Inclusion criteria were ≥ 18 years old with obesity (body mass index ≥ 30 kg/m²) who underwent either RIHR or LIHR. Data were analyzed for in-hospital mortality, length of stay (LOS), total hospital costs, and complications.</p><p><strong>Results: </strong>A total of 647 patients were included. Multivariable analysis showed RIHR was associated with a significantly lower risk of any complications (adjusted odds ratio [aOR] = 0.53, 95% confidence interval [CI]: 0.36, 0.77), shorter LOS (adjusted Beta [aBeta] = -0.94, 95%CI: -1.02, -0.86), and higher total hospital costs (aBeta = 5.62, 95%CI: 4.80, 6.44). Stratified analysis revealed that the lower risk of complications with RIHR was consistent across most subgroups, including age < 60 years (aOR = 0.56) and ≥ 60 years (aOR = 0.53), non-smokers (aOR = 0.53) and smokers (aOR = 0.48), non-hypertensive (aOR = 0.27) and hypertensive patients (aOR = 0.66), and non-diabetic (aOR = 0.53) and diabetic patients (aOR = 0.44), as well as patients admitted during 2017-2020 (aOR = 0.50).</p><p><strong>Conclusions: </strong>RIHR is associated with lower complication risk and shorter LOS, but higher hospital costs compared to LIHR for obese patients. These findings suggest that RIHR may offer better short-term outcomes for obese patients, which should be considered in surgical decision-making. Given the retrospective nature of this analysis and the potential for selection bias and residual confounding, future randomized controlled trials are warranted to confirm these findings and provide more robust evidence to guide surgical decision-making.</p>\",\"PeriodicalId\":13168,\"journal\":{\"name\":\"Hernia\",\"volume\":\"29 1\",\"pages\":\"122\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-03-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003516/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hernia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10029-025-03313-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03313-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
In-hospital outcomes of robotic versus laparoscopic inguinal hernia repair in obese patients: a national inpatient sample analysis 2005-2020.
Purpose: Obesity is associated with complications in surgical procedures and postoperative outcomes. This study aims to compare in-hospital outcomes of robotic inguinal hernia repair (RIHR) and laparoscopic inguinal hernia repair (LIHR) in obese patients.
Methods: Data from the National Inpatient Sample (NIS) from 2005 to 2020 were used in this study. Inclusion criteria were ≥ 18 years old with obesity (body mass index ≥ 30 kg/m²) who underwent either RIHR or LIHR. Data were analyzed for in-hospital mortality, length of stay (LOS), total hospital costs, and complications.
Results: A total of 647 patients were included. Multivariable analysis showed RIHR was associated with a significantly lower risk of any complications (adjusted odds ratio [aOR] = 0.53, 95% confidence interval [CI]: 0.36, 0.77), shorter LOS (adjusted Beta [aBeta] = -0.94, 95%CI: -1.02, -0.86), and higher total hospital costs (aBeta = 5.62, 95%CI: 4.80, 6.44). Stratified analysis revealed that the lower risk of complications with RIHR was consistent across most subgroups, including age < 60 years (aOR = 0.56) and ≥ 60 years (aOR = 0.53), non-smokers (aOR = 0.53) and smokers (aOR = 0.48), non-hypertensive (aOR = 0.27) and hypertensive patients (aOR = 0.66), and non-diabetic (aOR = 0.53) and diabetic patients (aOR = 0.44), as well as patients admitted during 2017-2020 (aOR = 0.50).
Conclusions: RIHR is associated with lower complication risk and shorter LOS, but higher hospital costs compared to LIHR for obese patients. These findings suggest that RIHR may offer better short-term outcomes for obese patients, which should be considered in surgical decision-making. Given the retrospective nature of this analysis and the potential for selection bias and residual confounding, future randomized controlled trials are warranted to confirm these findings and provide more robust evidence to guide surgical decision-making.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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