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。

IF 2.2 3区 医学 Q2 SURGERY
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}
引用次数: 0

摘要

背景:微创回肠袋-肛门吻合术(IPAA)已成为溃疡性结肠炎或家族性腺瘤性息肉病患者的标准治疗方法,与开放手术相比具有许多优点。然而,机器人手术对长期生活质量(QoL)的影响仍不明确。目的:采用经验证的患者报告预后仪分析机器人和腹腔镜IPAA术后的生活质量。设计:这项回顾性的、符合strobe的研究分析了158名在单一的三级医疗机构接受腹腔镜(n = 112)或机器人(n = 46) IPAA的患者。环境:数据在一个单一的三级保健机构收集。患者:该研究包括158例接受腹腔镜IPAA (n = 112)或机器人IPAA (n = 46)的患者。所有患者都进行了j -袋手术,并至少恢复了12个月的肠道连续性。干预:腹腔镜或机器人IPAA。主要结局指标:在回肠造口术后至少12个月,使用改良的、经过验证的回肠袋综合征严重程度评分(IPSS)调查来评估生活质量。结果:两组患者总体生活质量相似,重度或极重度眼袋相关症状发生率均较高(55.1%)。机器人IPAA手术时间较长,但出血量较少。IPSS评分较差与手工缝合IPAA伴粘膜切除术及术后脓毒性并发症相关。尽管存在这些挑战,92%的患者选择IPAA而不是回肠造口术。局限性:回顾性设计和潜在的无反应偏倚。修订后的IPSS调查可能无法完全反映生活质量的所有方面。结论:在这个队列中,机器人IPAA和腹腔镜IPAA产生了相当的生活质量,通过一个经过验证的患者报告的结果仪器来测量。无论手术方式如何,显著的眼袋功能障碍仍然普遍存在。可改变的因素,如手工缝合吻合和脓毒性并发症,对患者报告的结果产生负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.20
自引率
8.70%
发文量
145
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信