{"title":"机器人和腹腔镜右半结肠切除术治疗糖尿病患者结肠癌的效果比较：来自美国全国住院患者样本的结果。","authors":"Chih-Jung Chen, Hsin-Yuan Hung","doi":"10.1016/j.surg.2025.109597","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is a prevalent comorbid condition with colon cancer and may significantly impact surgical outcomes. This study aims to compare the postoperative outcomes between robotic-assisted right hemicolectomy and laparoscopic right hemicolectomy for right-side colon cancer in patients with co-existing diabetes mellitus.</p><p><strong>Methods: </strong>Data from Nationwide Inpatient Sample were analyzed retrospectively. Adult patients ≥20 years with diabetes mellitus who underwent either robotic-assisted right hemicolectomy or laparoscopic right hemicolectomy were included. Outcomes included in-hospital mortality, length of stay, total hospital costs, nonroutine discharge, major complications, and rates of conversion to open surgery. Univariate and multivariable logistic regression analyses were used to compare the outcomes between robotic-assisted right hemicolectomy and laparoscopic right hemicolectomy.</p><p><strong>Results: </strong>A total of 8,273 patients were included, with 1,119 undergoing robotic-assisted right hemicolectomy and 7,154 undergoing laparoscopic right hemicolectomy. Robotic-assisted right hemicolectomy was associated with shorter length of stay (adjusted beta, -0.86; 95% confidence interval, -0.89 to -0.83, P < .001), a lower risk of major complications (adjusted odds ratio, 0.80; 95% confidence interval, 0.67-0.96, P = .016), but greater total hospital costs (adjusted beta, 30.64; 95% confidence interval, 30.00-30.66, P < .001) compared with laparoscopic right hemicolectomy.</p><p><strong>Conclusion: </strong>Robotic-assisted right hemicolectomy offers significant advantages over laparoscopic right hemicolectomy for diabetic patients undergoing right hemicolectomy for colon cancer, including shorter hospital stays and lower rates of major complications. Despite greater total hospital costs, the improved short-term outcomes suggest that robotic-assisted right hemicolectomy is a safer and more effective surgical option for this patient population.</p>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"186 ","pages":"109597"},"PeriodicalIF":2.7000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of outcomes between robotic and laparoscopic right hemicolectomy for colon cancer in patients with diabetes: Results from the US Nationwide Inpatient Sample.\",\"authors\":\"Chih-Jung Chen, Hsin-Yuan Hung\",\"doi\":\"10.1016/j.surg.2025.109597\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diabetes mellitus is a prevalent comorbid condition with colon cancer and may significantly impact surgical outcomes. This study aims to compare the postoperative outcomes between robotic-assisted right hemicolectomy and laparoscopic right hemicolectomy for right-side colon cancer in patients with co-existing diabetes mellitus.</p><p><strong>Methods: </strong>Data from Nationwide Inpatient Sample were analyzed retrospectively. Adult patients ≥20 years with diabetes mellitus who underwent either robotic-assisted right hemicolectomy or laparoscopic right hemicolectomy were included. Outcomes included in-hospital mortality, length of stay, total hospital costs, nonroutine discharge, major complications, and rates of conversion to open surgery. Univariate and multivariable logistic regression analyses were used to compare the outcomes between robotic-assisted right hemicolectomy and laparoscopic right hemicolectomy.</p><p><strong>Results: </strong>A total of 8,273 patients were included, with 1,119 undergoing robotic-assisted right hemicolectomy and 7,154 undergoing laparoscopic right hemicolectomy. Robotic-assisted right hemicolectomy was associated with shorter length of stay (adjusted beta, -0.86; 95% confidence interval, -0.89 to -0.83, P < .001), a lower risk of major complications (adjusted odds ratio, 0.80; 95% confidence interval, 0.67-0.96, P = .016), but greater total hospital costs (adjusted beta, 30.64; 95% confidence interval, 30.00-30.66, P < .001) compared with laparoscopic right hemicolectomy.</p><p><strong>Conclusion: </strong>Robotic-assisted right hemicolectomy offers significant advantages over laparoscopic right hemicolectomy for diabetic patients undergoing right hemicolectomy for colon cancer, including shorter hospital stays and lower rates of major complications. Despite greater total hospital costs, the improved short-term outcomes suggest that robotic-assisted right hemicolectomy is a safer and more effective surgical option for this patient population.</p>\",\"PeriodicalId\":22152,\"journal\":{\"name\":\"Surgery\",\"volume\":\"186 \",\"pages\":\"109597\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.surg.2025.109597\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.surg.2025.109597","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/9 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Comparison of outcomes between robotic and laparoscopic right hemicolectomy for colon cancer in patients with diabetes: Results from the US Nationwide Inpatient Sample.
Background: Diabetes mellitus is a prevalent comorbid condition with colon cancer and may significantly impact surgical outcomes. This study aims to compare the postoperative outcomes between robotic-assisted right hemicolectomy and laparoscopic right hemicolectomy for right-side colon cancer in patients with co-existing diabetes mellitus.
Methods: Data from Nationwide Inpatient Sample were analyzed retrospectively. Adult patients ≥20 years with diabetes mellitus who underwent either robotic-assisted right hemicolectomy or laparoscopic right hemicolectomy were included. Outcomes included in-hospital mortality, length of stay, total hospital costs, nonroutine discharge, major complications, and rates of conversion to open surgery. Univariate and multivariable logistic regression analyses were used to compare the outcomes between robotic-assisted right hemicolectomy and laparoscopic right hemicolectomy.
Results: A total of 8,273 patients were included, with 1,119 undergoing robotic-assisted right hemicolectomy and 7,154 undergoing laparoscopic right hemicolectomy. Robotic-assisted right hemicolectomy was associated with shorter length of stay (adjusted beta, -0.86; 95% confidence interval, -0.89 to -0.83, P < .001), a lower risk of major complications (adjusted odds ratio, 0.80; 95% confidence interval, 0.67-0.96, P = .016), but greater total hospital costs (adjusted beta, 30.64; 95% confidence interval, 30.00-30.66, P < .001) compared with laparoscopic right hemicolectomy.
Conclusion: Robotic-assisted right hemicolectomy offers significant advantages over laparoscopic right hemicolectomy for diabetic patients undergoing right hemicolectomy for colon cancer, including shorter hospital stays and lower rates of major complications. Despite greater total hospital costs, the improved short-term outcomes suggest that robotic-assisted right hemicolectomy is a safer and more effective surgical option for this patient population.
期刊介绍：
For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
