Tommaso Violante, Davide Ferrari, Nicholas P McKenna, William R G Perry, Eric J Dozois, Kevin T Behm, Kellie L Mathis, David W Larson
{"title":"机器人和腹腔镜IPAA后的肠功能和生活质量:一项患者报告的结果研究。","authors":"Tommaso Violante, Davide Ferrari, Nicholas P McKenna, William R G Perry, Eric J Dozois, Kevin T Behm, Kellie L Mathis, David W Larson","doi":"10.1007/s11701-025-02488-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis or familial adenomatous polyposis, offering numerous benefits over open surgery. However, the impact of robotic surgery on long-term quality of life (QoL) remains poorly defined.</p><p><strong>Objective: </strong>To analyze QoL after robotic and laparoscopic IPAA using a validated patient-reported outcome instrument.</p><p><strong>Design: </strong>This retrospective, STROBE-compliant study analyzed 158 patients who underwent laparoscopic (n = 112) or robotic (n = 46) IPAA at a single, tertiary-care institution.</p><p><strong>Settings: </strong>Data were collected at a single, tertiary-care institution.</p><p><strong>Patients: </strong>The study included 158 patients who underwent laparoscopic (n = 112) or robotic (n = 46) IPAA. All patients had a J-pouch procedure and had at least 12 months of restored intestinal continuity.</p><p><strong>Interventions: </strong>Laparoscopic or robotic IPAA.</p><p><strong>Main outcome measures: </strong>QoL was assessed using a modified, validated Ileoanal Pouch Syndrome Severity Score (IPSS) survey at least 12 months after ileostomy closure.</p><p><strong>Results: </strong>Both groups experienced similar overall QoL, with a high prevalence of severe or extremely severe pouch-related symptoms (55.1%). Robotic IPAA was associated with longer operative times but less blood loss. Worse IPSS scores correlated with hand-sewn IPAA with mucosectomy and postoperative septic complications. Despite these challenges, 92% of patients preferred IPAA over ileostomy.</p><p><strong>Limitations: </strong>Retrospective design and potential for non-response bias. The modified IPSS survey may not fully capture all aspects of QoL.</p><p><strong>Conclusions: </strong>In this cohort, robotic and laparoscopic IPAA resulted in comparable QoL as measured by a validated patient-reported outcome instrument. Significant pouch dysfunction remains prevalent regardless of surgical approach. Modifiable factors, such as hand-sewn anastomosis and septic complications, negatively impact patient-reported outcomes.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"19 1","pages":"360"},"PeriodicalIF":2.2000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bowel function and quality of life after robotic and laparoscopic IPAA: a patient-reported outcomes study.\",\"authors\":\"Tommaso Violante, Davide Ferrari, Nicholas P McKenna, William R G Perry, Eric J Dozois, Kevin T Behm, Kellie L Mathis, David W Larson\",\"doi\":\"10.1007/s11701-025-02488-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Minimally invasive ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis or familial adenomatous polyposis, offering numerous benefits over open surgery. However, the impact of robotic surgery on long-term quality of life (QoL) remains poorly defined.</p><p><strong>Objective: </strong>To analyze QoL after robotic and laparoscopic IPAA using a validated patient-reported outcome instrument.</p><p><strong>Design: </strong>This retrospective, STROBE-compliant study analyzed 158 patients who underwent laparoscopic (n = 112) or robotic (n = 46) IPAA at a single, tertiary-care institution.</p><p><strong>Settings: </strong>Data were collected at a single, tertiary-care institution.</p><p><strong>Patients: </strong>The study included 158 patients who underwent laparoscopic (n = 112) or robotic (n = 46) IPAA. All patients had a J-pouch procedure and had at least 12 months of restored intestinal continuity.</p><p><strong>Interventions: </strong>Laparoscopic or robotic IPAA.</p><p><strong>Main outcome measures: </strong>QoL was assessed using a modified, validated Ileoanal Pouch Syndrome Severity Score (IPSS) survey at least 12 months after ileostomy closure.</p><p><strong>Results: </strong>Both groups experienced similar overall QoL, with a high prevalence of severe or extremely severe pouch-related symptoms (55.1%). Robotic IPAA was associated with longer operative times but less blood loss. Worse IPSS scores correlated with hand-sewn IPAA with mucosectomy and postoperative septic complications. Despite these challenges, 92% of patients preferred IPAA over ileostomy.</p><p><strong>Limitations: </strong>Retrospective design and potential for non-response bias. The modified IPSS survey may not fully capture all aspects of QoL.</p><p><strong>Conclusions: </strong>In this cohort, robotic and laparoscopic IPAA resulted in comparable QoL as measured by a validated patient-reported outcome instrument. Significant pouch dysfunction remains prevalent regardless of surgical approach. Modifiable factors, such as hand-sewn anastomosis and septic complications, negatively impact patient-reported outcomes.</p>\",\"PeriodicalId\":47616,\"journal\":{\"name\":\"Journal of Robotic Surgery\",\"volume\":\"19 1\",\"pages\":\"360\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Robotic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11701-025-02488-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11701-025-02488-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Bowel function and quality of life after robotic and laparoscopic IPAA: a patient-reported outcomes study.
Background: Minimally invasive ileal pouch-anal anastomosis (IPAA) has become the standard of care for patients with ulcerative colitis or familial adenomatous polyposis, offering numerous benefits over open surgery. However, the impact of robotic surgery on long-term quality of life (QoL) remains poorly defined.
Objective: To analyze QoL after robotic and laparoscopic IPAA using a validated patient-reported outcome instrument.
Design: This retrospective, STROBE-compliant study analyzed 158 patients who underwent laparoscopic (n = 112) or robotic (n = 46) IPAA at a single, tertiary-care institution.
Settings: Data were collected at a single, tertiary-care institution.
Patients: The study included 158 patients who underwent laparoscopic (n = 112) or robotic (n = 46) IPAA. All patients had a J-pouch procedure and had at least 12 months of restored intestinal continuity.
Interventions: Laparoscopic or robotic IPAA.
Main outcome measures: QoL was assessed using a modified, validated Ileoanal Pouch Syndrome Severity Score (IPSS) survey at least 12 months after ileostomy closure.
Results: Both groups experienced similar overall QoL, with a high prevalence of severe or extremely severe pouch-related symptoms (55.1%). Robotic IPAA was associated with longer operative times but less blood loss. Worse IPSS scores correlated with hand-sewn IPAA with mucosectomy and postoperative septic complications. Despite these challenges, 92% of patients preferred IPAA over ileostomy.
Limitations: Retrospective design and potential for non-response bias. The modified IPSS survey may not fully capture all aspects of QoL.
Conclusions: In this cohort, robotic and laparoscopic IPAA resulted in comparable QoL as measured by a validated patient-reported outcome instrument. Significant pouch dysfunction remains prevalent regardless of surgical approach. Modifiable factors, such as hand-sewn anastomosis and septic complications, negatively impact patient-reported outcomes.
期刊介绍:
The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.