Efficacy of a robotic stapler on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer
Purpose Clinical evidence demonstrating risk factors for anastomotic leakage including robotic staplers has remained limited, even though the use of robotic surgery has increased substantially. The purpose of this study was to evaluate the effects of robotic staplers on symptomatic anastomotic leaka...
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| Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2022-01, Vol.52 (1), p.120-128 |
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| creator | Chen, Kai Shiomi, Akio Kagawa, Hiroyasu Hino, Hitoshi Manabe, Shoichi Yamaoka, Yusuke Kato, Shunichiro Hanaoka, Marie Saito, Kentaro Maeda, Chikara Kojima, Tadahiro Shioi, Ikuma Nanishi, Kenji Tanaka, Yusuke Kasai, Shunsuke |
| description | Purpose
Clinical evidence demonstrating risk factors for anastomotic leakage including robotic staplers has remained limited, even though the use of robotic surgery has increased substantially. The purpose of this study was to evaluate the effects of robotic staplers on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer.
Methods
A total of 427 consecutive patients with primary rectal cancer who underwent robotic low anterior resection without diverting stoma were investigated retrospectively. Symptomatic anastomotic leakage was defined as anastomotic leakage of Clavien–Dindo Grade ≥ II. We compared the symptomatic anastomotic leakage rates between manual and robotic staplers using propensity score matching and investigated the risk factors for symptomatic anastomotic leakage.
Results
After propensity score matching, 168 pairs of manual and robotic stapler cases were selected. The symptomatic anastomotic leakage rate was significantly higher for manual staplers (6.5%) than for robotic staplers (1.2%,
p
= 0.02). In a multivariate analysis, the use of a manual stapler (
p
= 0.04, OR 4.86, 95% CI 1.08–21.8) and anastomosis |
| doi_str_mv | 10.1007/s00595-021-02313-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2539880583</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2539880583</sourcerecordid><originalsourceid>FETCH-LOGICAL-c437t-e01633c7c54b43f187ed897c403147554965947afb8dacbc7ca1ab2ab08bcb4b3</originalsourceid><addsrcrecordid>eNp9kE1PAyEURYnR2Fr9Ay4MSzejj4GZYZamqR9JEze6Jg_KNFNnhgo0pv9e-mGXLgg8OPcmHEJuGTwwgOoxABR1kUHO0uKMZ-UZGTPByyyXjJ-TMdSCZSyv2YhchbACyIUEuCQjLhgDIeWYxFnTtAbNlrqGIvVOu9gaGiKuO-upG2jY9uvoetxd44AhnfdIZ_ELl5a2wynVuZ-EROtb56m3wZrYpoZmP5mIHTU4GOuvyUWDXbA3x31CPp9nH9PXbP7-8jZ9mmdG8CpmFljJualMIbTgDZOVXci6MgI4E1VRiLosalFho-UCjU4gMtQ5apDaaKH5hNwfetfefW9siKpvg7Fdh4N1m6DygtdSQiF5QvMDarwLwdtGrX3bo98qBmpnWx1sq2Rb7W2rMoXujv0b3dvFKfKnNwH8AIT0NCytVyu38UP683-1v9MbjI0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2539880583</pqid></control><display><type>article</type><title>Efficacy of a robotic stapler on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Chen, Kai ; Shiomi, Akio ; Kagawa, Hiroyasu ; Hino, Hitoshi ; Manabe, Shoichi ; Yamaoka, Yusuke ; Kato, Shunichiro ; Hanaoka, Marie ; Saito, Kentaro ; Maeda, Chikara ; Kojima, Tadahiro ; Shioi, Ikuma ; Nanishi, Kenji ; Tanaka, Yusuke ; Kasai, Shunsuke</creator><creatorcontrib>Chen, Kai ; Shiomi, Akio ; Kagawa, Hiroyasu ; Hino, Hitoshi ; Manabe, Shoichi ; Yamaoka, Yusuke ; Kato, Shunichiro ; Hanaoka, Marie ; Saito, Kentaro ; Maeda, Chikara ; Kojima, Tadahiro ; Shioi, Ikuma ; Nanishi, Kenji ; Tanaka, Yusuke ; Kasai, Shunsuke</creatorcontrib><description>Purpose
Clinical evidence demonstrating risk factors for anastomotic leakage including robotic staplers has remained limited, even though the use of robotic surgery has increased substantially. The purpose of this study was to evaluate the effects of robotic staplers on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer.
Methods
A total of 427 consecutive patients with primary rectal cancer who underwent robotic low anterior resection without diverting stoma were investigated retrospectively. Symptomatic anastomotic leakage was defined as anastomotic leakage of Clavien–Dindo Grade ≥ II. We compared the symptomatic anastomotic leakage rates between manual and robotic staplers using propensity score matching and investigated the risk factors for symptomatic anastomotic leakage.
Results
After propensity score matching, 168 pairs of manual and robotic stapler cases were selected. The symptomatic anastomotic leakage rate was significantly higher for manual staplers (6.5%) than for robotic staplers (1.2%,
p
= 0.02). In a multivariate analysis, the use of a manual stapler (
p
= 0.04, OR 4.86, 95% CI 1.08–21.8) and anastomosis < 4 cm from the anal verge (
p
< 0.01, OR 4.36, 95% CI 1.48–12.9) were identified as independent risk factors for symptomatic anastomotic leakage.
Conclusions
Robotic stapler use was associated with a significantly decreased rate of anastomotic leakage in robotic low anterior resection without diverting stoma for rectal cancer.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-021-02313-6</identifier><identifier>PMID: 34110488</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anastomotic Leak - surgery ; Digestive System Surgical Procedures - methods ; Female ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Propensity Score ; Rectal Neoplasms - secondary ; Retrospective Studies ; Risk Factors ; Robotic Surgical Procedures - methods ; Surgery ; Surgical Oncology ; Surgical Staplers ; Surgical Stapling - methods ; Treatment Outcome</subject><ispartof>Surgery today (Tokyo, Japan), 2022-01, Vol.52 (1), p.120-128</ispartof><rights>Springer Nature Singapore Pte Ltd. 2021</rights><rights>2021. Springer Nature Singapore Pte Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-e01633c7c54b43f187ed897c403147554965947afb8dacbc7ca1ab2ab08bcb4b3</citedby><cites>FETCH-LOGICAL-c437t-e01633c7c54b43f187ed897c403147554965947afb8dacbc7ca1ab2ab08bcb4b3</cites><orcidid>0000-0002-6800-5292</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-021-02313-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-021-02313-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34110488$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Kai</creatorcontrib><creatorcontrib>Shiomi, Akio</creatorcontrib><creatorcontrib>Kagawa, Hiroyasu</creatorcontrib><creatorcontrib>Hino, Hitoshi</creatorcontrib><creatorcontrib>Manabe, Shoichi</creatorcontrib><creatorcontrib>Yamaoka, Yusuke</creatorcontrib><creatorcontrib>Kato, Shunichiro</creatorcontrib><creatorcontrib>Hanaoka, Marie</creatorcontrib><creatorcontrib>Saito, Kentaro</creatorcontrib><creatorcontrib>Maeda, Chikara</creatorcontrib><creatorcontrib>Kojima, Tadahiro</creatorcontrib><creatorcontrib>Shioi, Ikuma</creatorcontrib><creatorcontrib>Nanishi, Kenji</creatorcontrib><creatorcontrib>Tanaka, Yusuke</creatorcontrib><creatorcontrib>Kasai, Shunsuke</creatorcontrib><title>Efficacy of a robotic stapler on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purpose
Clinical evidence demonstrating risk factors for anastomotic leakage including robotic staplers has remained limited, even though the use of robotic surgery has increased substantially. The purpose of this study was to evaluate the effects of robotic staplers on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer.
Methods
A total of 427 consecutive patients with primary rectal cancer who underwent robotic low anterior resection without diverting stoma were investigated retrospectively. Symptomatic anastomotic leakage was defined as anastomotic leakage of Clavien–Dindo Grade ≥ II. We compared the symptomatic anastomotic leakage rates between manual and robotic staplers using propensity score matching and investigated the risk factors for symptomatic anastomotic leakage.
Results
After propensity score matching, 168 pairs of manual and robotic stapler cases were selected. The symptomatic anastomotic leakage rate was significantly higher for manual staplers (6.5%) than for robotic staplers (1.2%,
p
= 0.02). In a multivariate analysis, the use of a manual stapler (
p
= 0.04, OR 4.86, 95% CI 1.08–21.8) and anastomosis < 4 cm from the anal verge (
p
< 0.01, OR 4.36, 95% CI 1.48–12.9) were identified as independent risk factors for symptomatic anastomotic leakage.
Conclusions
Robotic stapler use was associated with a significantly decreased rate of anastomotic leakage in robotic low anterior resection without diverting stoma for rectal cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomotic Leak - surgery</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Propensity Score</subject><subject>Rectal Neoplasms - secondary</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Surgical Staplers</subject><subject>Surgical Stapling - methods</subject><subject>Treatment Outcome</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PAyEURYnR2Fr9Ay4MSzejj4GZYZamqR9JEze6Jg_KNFNnhgo0pv9e-mGXLgg8OPcmHEJuGTwwgOoxABR1kUHO0uKMZ-UZGTPByyyXjJ-TMdSCZSyv2YhchbACyIUEuCQjLhgDIeWYxFnTtAbNlrqGIvVOu9gaGiKuO-upG2jY9uvoetxd44AhnfdIZ_ELl5a2wynVuZ-EROtb56m3wZrYpoZmP5mIHTU4GOuvyUWDXbA3x31CPp9nH9PXbP7-8jZ9mmdG8CpmFljJualMIbTgDZOVXci6MgI4E1VRiLosalFho-UCjU4gMtQ5apDaaKH5hNwfetfefW9siKpvg7Fdh4N1m6DygtdSQiF5QvMDarwLwdtGrX3bo98qBmpnWx1sq2Rb7W2rMoXujv0b3dvFKfKnNwH8AIT0NCytVyu38UP683-1v9MbjI0</recordid><startdate>20220101</startdate><enddate>20220101</enddate><creator>Chen, Kai</creator><creator>Shiomi, Akio</creator><creator>Kagawa, Hiroyasu</creator><creator>Hino, Hitoshi</creator><creator>Manabe, Shoichi</creator><creator>Yamaoka, Yusuke</creator><creator>Kato, Shunichiro</creator><creator>Hanaoka, Marie</creator><creator>Saito, Kentaro</creator><creator>Maeda, Chikara</creator><creator>Kojima, Tadahiro</creator><creator>Shioi, Ikuma</creator><creator>Nanishi, Kenji</creator><creator>Tanaka, Yusuke</creator><creator>Kasai, Shunsuke</creator><general>Springer Singapore</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6800-5292</orcidid></search><sort><creationdate>20220101</creationdate><title>Efficacy of a robotic stapler on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer</title><author>Chen, Kai ; Shiomi, Akio ; Kagawa, Hiroyasu ; Hino, Hitoshi ; Manabe, Shoichi ; Yamaoka, Yusuke ; Kato, Shunichiro ; Hanaoka, Marie ; Saito, Kentaro ; Maeda, Chikara ; Kojima, Tadahiro ; Shioi, Ikuma ; Nanishi, Kenji ; Tanaka, Yusuke ; Kasai, Shunsuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-e01633c7c54b43f187ed897c403147554965947afb8dacbc7ca1ab2ab08bcb4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomotic Leak - surgery</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Propensity Score</topic><topic>Rectal Neoplasms - secondary</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Surgical Staplers</topic><topic>Surgical Stapling - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Kai</creatorcontrib><creatorcontrib>Shiomi, Akio</creatorcontrib><creatorcontrib>Kagawa, Hiroyasu</creatorcontrib><creatorcontrib>Hino, Hitoshi</creatorcontrib><creatorcontrib>Manabe, Shoichi</creatorcontrib><creatorcontrib>Yamaoka, Yusuke</creatorcontrib><creatorcontrib>Kato, Shunichiro</creatorcontrib><creatorcontrib>Hanaoka, Marie</creatorcontrib><creatorcontrib>Saito, Kentaro</creatorcontrib><creatorcontrib>Maeda, Chikara</creatorcontrib><creatorcontrib>Kojima, Tadahiro</creatorcontrib><creatorcontrib>Shioi, Ikuma</creatorcontrib><creatorcontrib>Nanishi, Kenji</creatorcontrib><creatorcontrib>Tanaka, Yusuke</creatorcontrib><creatorcontrib>Kasai, Shunsuke</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Kai</au><au>Shiomi, Akio</au><au>Kagawa, Hiroyasu</au><au>Hino, Hitoshi</au><au>Manabe, Shoichi</au><au>Yamaoka, Yusuke</au><au>Kato, Shunichiro</au><au>Hanaoka, Marie</au><au>Saito, Kentaro</au><au>Maeda, Chikara</au><au>Kojima, Tadahiro</au><au>Shioi, Ikuma</au><au>Nanishi, Kenji</au><au>Tanaka, Yusuke</au><au>Kasai, Shunsuke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of a robotic stapler on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2022-01-01</date><risdate>2022</risdate><volume>52</volume><issue>1</issue><spage>120</spage><epage>128</epage><pages>120-128</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purpose
Clinical evidence demonstrating risk factors for anastomotic leakage including robotic staplers has remained limited, even though the use of robotic surgery has increased substantially. The purpose of this study was to evaluate the effects of robotic staplers on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer.
Methods
A total of 427 consecutive patients with primary rectal cancer who underwent robotic low anterior resection without diverting stoma were investigated retrospectively. Symptomatic anastomotic leakage was defined as anastomotic leakage of Clavien–Dindo Grade ≥ II. We compared the symptomatic anastomotic leakage rates between manual and robotic staplers using propensity score matching and investigated the risk factors for symptomatic anastomotic leakage.
Results
After propensity score matching, 168 pairs of manual and robotic stapler cases were selected. The symptomatic anastomotic leakage rate was significantly higher for manual staplers (6.5%) than for robotic staplers (1.2%,
p
= 0.02). In a multivariate analysis, the use of a manual stapler (
p
= 0.04, OR 4.86, 95% CI 1.08–21.8) and anastomosis < 4 cm from the anal verge (
p
< 0.01, OR 4.36, 95% CI 1.48–12.9) were identified as independent risk factors for symptomatic anastomotic leakage.
Conclusions
Robotic stapler use was associated with a significantly decreased rate of anastomotic leakage in robotic low anterior resection without diverting stoma for rectal cancer.</abstract><cop>Singapore</cop><pub>Springer Singapore</pub><pmid>34110488</pmid><doi>10.1007/s00595-021-02313-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6800-5292</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0941-1291 |
| ispartof | Surgery today (Tokyo, Japan), 2022-01, Vol.52 (1), p.120-128 |
| issn | 0941-1291 1436-2813 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Anastomotic Leak - surgery Digestive System Surgical Procedures - methods Female Humans Male Medicine Medicine & Public Health Middle Aged Original Article Propensity Score Rectal Neoplasms - secondary Retrospective Studies Risk Factors Robotic Surgical Procedures - methods Surgery Surgical Oncology Surgical Staplers Surgical Stapling - methods Treatment Outcome |
| title | Efficacy of a robotic stapler on symptomatic anastomotic leakage in robotic low anterior resection for rectal cancer |
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