Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity

Feinberg, Adina; Elnahas, Ahmad; Bashir, Shaheena; Cleghorn, Michelle C.; Quereshy, Fayez A.

doi:10.1503/cjs.016615

Cited by 32 publications

(34 citation statements)

References 31 publications

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“…The initial search, as illustrated in Figure 1 , resulted in 3636 results. After removing duplicates and filtering, the remaining 629 abstracts were read in their entirety by the two reviewers, as outlined by AMSTAR [ 15 ]. Independent notes were taken on a shared spreadsheet.…”

Section: Resultsmentioning

confidence: 99%

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Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

Kruse¹,

Beane²

2018

J Med Internet Res

154

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BackgroundHealth information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature.ObjectiveThe purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes.MethodsWe queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR).ResultsWe narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively.ConclusionsA strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames.

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Section: Resultsmentioning

confidence: 99%

“…After the initial search was completed, we removed duplicates and filtered. Each member of the review team read all of the remaining abstracts to ensure they were reviewed at least twice, as outlined by AMSTAR [ 15 ]. Independent notes were taken on a shared spreadsheet to inspire discussion.…”

Section: Methodsmentioning

confidence: 99%

Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

Kruse¹,

Beane²

2018

J Med Internet Res

154

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“…Robotic surgery, notwithstanding the cost, can help in overcoming the technical challenges associated with laparoscopy and has been shown to offer comparable short-term oncologic outcomes and anastomotic leak rates. [31][32][33] Comprehensive longitudinal and randomized data comparing emerging (transanal total mesorectal excision) and current modalities (laparoscopy, robotic surgery) in CRC are yet to materialize. The ongoing COLRAR (NCT01423214) and COLOR III (NCT02736942) trials are expected to provide more information on the topic of QOL in this vulnerable patient population.…”

Section: Discussionmentioning

confidence: 99%

The impact of surgical modality on self-reported body image, quality of life and survivorship after anterior resection for colorectal cancer – a mixed methods study

Hirpara

Azin

Mulcahy

et al. 2019

cjs

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Background: There is growing enthusiasm for robotic and transanal surgery as an alternative to open or laparoscopic surgery for colorectal cancer (CRC). We examined the impact of surgical modality on body image and quality of life (QOL) in patients receiving anterior resection for CRC. Methods: We used a mixed-methods approach, consisting of a chart review and semistructured interviews with CRC patients, at least 8 months after surgery. We assessed cosmetic outcomes and QOL using validated questionnaires. Results: Thirty patients were stratified into open (n = 8), laparoscopic (n = 12) and robotic (n = 10) groups. Mean body image scores were significantly higher (i.e., poorer body image) in patients receiving open surgery (mean difference [MD] +5.7 with laparoscopy, p < 0.001). Open surgery was more detrimental to physical function, including strenuous activities, prolonged ambulation and self-care (MD-11.6 with laparoscopy, p = 0.039). Patients receiving laparoscopic surgery reported superior role (MD +27.6 with open surgery, p = 0.002) and social function (MD +13.7 with open surgery, p = 0.042), including the ability to enjoy hobbies, family life and social activities. Surgical modality did not affect emotional and cognitive function or symptoms including genitourinary function, pain and defecation. Conclusion: The negative impact of open surgery on body image and physical function warrants further educational interventions for patients. The protective effect of laparoscopy on role and function may be associated with "tumour factors" that are unaccounted for in the European Organization for Research and Treatment of Cancer questionnaires. Open surgery is detrimental to body image and physical function in patients receiving anterior resection for CRC. Prospective randomized studies are required to validate these findings. Contexte : On observe un intérêt croissant pour la chirurgie transanale robotique comme solution de rechange à la chirurgie ouverte ou laparoscopique dans les cas de cancer colorectal (CCR). Nous avons analysé l'impact de la modalité chirurgicale sur l'image corporelle et la qualité de vie (QdV) chez les patients ayant subi une résection antérieure pour CCR. Méthodes : Nous avons utilisé une approche à méthodologie mixte, composée d'une revue des dossiers et d'entrevues semi-structurées avec des patients atteints de CCR, au moins 8 mois après la chirurgie. Nous avons évalué les résultats cosmétiques et la QdV au moyen de questionnaires validés. Résultats : Trente patients ont été stratifiés en 3 groupes : chirurgie ouverte (n = 8), laparoscopique (n = 12) et robotique (n = 10). Les scores moyens pour l'image corporelle ont été significativement plus élevés (c.-à-d., image corporelle plus négative) chez les patients ayant subi une chirurgie ouverte (différence moyenne [DM] +5,7 avec la laparoscopie, p < 0,001). La chirurgie ouverte a été plus nuisible au fonctionnement physique, y compris aux activités exigeantes, à la déambulation prolongée et à l'autosoin (DM-11,6 avec la laparoscopie, p = 0,0...

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“…Many studies comparing LC and RC MIS options show no significant difference in postoperative complication rates, though several show decreased hospital LOS and conversion rates for RC. 1 , 2 , 4 , 6 , 18 – 20 Some studies show an advantage related to the intracorporeal anastomosis compared with the extracorporeal anastomosis for both RC and LC options. 6 , 20 – 22 The learning curve for RC appears to be shorter than that for LC, and the adoption of RC is increasing, especially for rectal resections in the pelvis and for anastomotic suturing that accompanies colectomies.…”

Section: Discussionmentioning

confidence: 99%

A Regional and National Database Comparison of Colorectal Outcomes

Batool¹,

Collins

Albright

et al. 2018

JSLS

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Background and Objectives:The traditional open approach is still a common option for colectomy and the most common option chosen for rectal resections for cancer. Randomized trials and large database studies have reported the merits of the minimally invasive approach, while studies comparing laparoscopic and robotic options have reported inconsistent results.Methods:This study was designed to compare open, laparoscopic, and robotic colorectal surgery outcomes in protocol-driven regional and national databases. Logistic and multiple linear regression analyses were used to compare standard 30-day colorectal outcomes in the Michigan Surgical Quality Collaborative (MSQC) and American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) databases. The primary outcome was overall complications.Results:A total of 10,054 MSQC patients (open 37.5%, laparoscopic 48.8%, and robotic 13.6%) and 80,535 ACS-NSQIP patients (open 25.0%, laparoscopic 67.1%, and robotic 7.9%) met inclusion criteria. Overall complications and surgical site infections were significantly favorable for the laparoscopic and robotic approaches compared with the open approach. Anastomotic leaks were significantly fewer for the laparoscopic and robotic approaches compared with the open approach in ACS-NSQIP, while there was no significant difference between robotic and open approaches in MSQC. Laparoscopic complications were significantly less than robotic complications in MSQC but significantly more in ACS-NSQIP. Laparoscopic 30-day mortality was significantly less than for the robotic approach in MSQC, but there was no difference in ACS-NSQIP.Conclusion:Minimally invasive colorectal surgery is associated with fewer complications and has several other outcomes advantages compared with the traditional open approach. Individual complication comparisons vary between databases, and caution should be exercised when interpreting results in context.

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Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity

Cited by 32 publications

References 31 publications

Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

The impact of surgical modality on self-reported body image, quality of life and survivorship after anterior resection for colorectal cancer – a mixed methods study

A Regional and National Database Comparison of Colorectal Outcomes

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