Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan
Background Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This...
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| creator | Yatabe, Yusuke Hanaoka, Marie Hanazawa, Ryoichi Hirakawa, Akihiro Mukai, Toshiki Kimura, Kei Yamanoi, Koji Kono, Jin Yokota, Mitsuru Takahashi, Hiroki Kobayashi, Akihiro Kobayashi, Kenji Ichikawa, Nobuki Yasui, Masayoshi Nakane, Keita Yamamoto, Manabu Takenaka, Atsushi Nakamura, Yuya Takemasa, Ichiro Yabusaki, Norimitsu Akamoto, Shintaro Tatarano, Shuichi Murata, Kohei Manabe, Tatsuya Fujimura, Tetsuya Kawamura, Mikio Egi, Hiroyuki Yamaguchi, Shigeki Terai, Yoshito Inoue, Shigetaka Ito, Akihiro Kinugasa, Yusuke |
| description | Background
Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This study aimed to evaluate the safety and efficacy of robot-assisted PE (RPE) by comparing the outcomes of open PE (OPE) with those of conventional laparoscopic PE (LPE) for treating pelvic tumors.
Methods
Following the ethics committee approval, a multicenter retrospective analysis of patients who underwent pelvic exenteration between January 2012 and October 2022 was conducted. Data on patient demographics, tumor characteristics, and perioperative outcomes were collected. A 1:1 propensity score-matched analysis was performed to minimize group selection bias.
Results
In total, 261 patients met the study criteria, of whom 61 underwent RPE, 90 underwent OPE, and 110 underwent LPE. After propensity score matching, 50 pairs were created for RPE and OPE and 59 for RPE and LPE. RPE was associated with significantly less blood loss (RPE vs. OPE: 408 mL vs. 2385 ml,
p
|
| doi_str_mv | 10.1007/s00464-024-10966-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3070793642</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3086152615</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-79865ca79f53a42beeb6d86f88f0cadb4c1c908ada98481a1dfcb3477ecdab6c3</originalsourceid><addsrcrecordid>eNp9kUtv1TAQRi0EopfCH2CBLLFhY_Arjs0OVeWlSkgI1tbEmUCqxA520nJX_HV8e1uQWLCwZjFnzoz8EfJU8JeC8_ZV4VwbzbjUTHBnDLu-R3ZCK8mkFPY-2XGnOJOt0yfkUSmXvPJONA_JibLWGqnEjvz6nLq0joFeYS5boWnBSCH2dIIFciohLbW54HRVC_7EuGKGdUyx0CHlu0aAGDC_pkDnbaq2G4wu-WAr47pnM6zhO_bVDNO-jIWOkX6sG-Jj8mCAqeCT23pKvr49_3L2nl18evfh7M0FC7IxK2udNU2A1g2NAi07xM701gzWDjxA3-kgguMWenBWWwGiH0KndNti6KEzQZ2SF0dvPerHhmX181gCThNETFvxire8dcpoWdHn_6CXacv18ANljWhkfZWSRyrUXyoZB7_kcYa894L7Qzz-GI-v8fibePx1HXp2q966Gfs_I3d5VEAdgVJb8Rvmv7v_o_0NbkGe1w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3086152615</pqid></control><display><type>article</type><title>Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Yatabe, Yusuke ; Hanaoka, Marie ; Hanazawa, Ryoichi ; Hirakawa, Akihiro ; Mukai, Toshiki ; Kimura, Kei ; Yamanoi, Koji ; Kono, Jin ; Yokota, Mitsuru ; Takahashi, Hiroki ; Kobayashi, Akihiro ; Kobayashi, Kenji ; Ichikawa, Nobuki ; Yasui, Masayoshi ; Nakane, Keita ; Yamamoto, Manabu ; Takenaka, Atsushi ; Nakamura, Yuya ; Takemasa, Ichiro ; Yabusaki, Norimitsu ; Akamoto, Shintaro ; Tatarano, Shuichi ; Murata, Kohei ; Manabe, Tatsuya ; Fujimura, Tetsuya ; Kawamura, Mikio ; Egi, Hiroyuki ; Yamaguchi, Shigeki ; Terai, Yoshito ; Inoue, Shigetaka ; Ito, Akihiro ; Kinugasa, Yusuke</creator><creatorcontrib>Yatabe, Yusuke ; Hanaoka, Marie ; Hanazawa, Ryoichi ; Hirakawa, Akihiro ; Mukai, Toshiki ; Kimura, Kei ; Yamanoi, Koji ; Kono, Jin ; Yokota, Mitsuru ; Takahashi, Hiroki ; Kobayashi, Akihiro ; Kobayashi, Kenji ; Ichikawa, Nobuki ; Yasui, Masayoshi ; Nakane, Keita ; Yamamoto, Manabu ; Takenaka, Atsushi ; Nakamura, Yuya ; Takemasa, Ichiro ; Yabusaki, Norimitsu ; Akamoto, Shintaro ; Tatarano, Shuichi ; Murata, Kohei ; Manabe, Tatsuya ; Fujimura, Tetsuya ; Kawamura, Mikio ; Egi, Hiroyuki ; Yamaguchi, Shigeki ; Terai, Yoshito ; Inoue, Shigetaka ; Ito, Akihiro ; Kinugasa, Yusuke</creatorcontrib><description>Background
Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This study aimed to evaluate the safety and efficacy of robot-assisted PE (RPE) by comparing the outcomes of open PE (OPE) with those of conventional laparoscopic PE (LPE) for treating pelvic tumors.
Methods
Following the ethics committee approval, a multicenter retrospective analysis of patients who underwent pelvic exenteration between January 2012 and October 2022 was conducted. Data on patient demographics, tumor characteristics, and perioperative outcomes were collected. A 1:1 propensity score-matched analysis was performed to minimize group selection bias.
Results
In total, 261 patients met the study criteria, of whom 61 underwent RPE, 90 underwent OPE, and 110 underwent LPE. After propensity score matching, 50 pairs were created for RPE and OPE and 59 for RPE and LPE. RPE was associated with significantly less blood loss (RPE vs. OPE: 408 mL vs. 2385 ml,
p
< 0.001), lower transfusion rate (RPE vs. OPE: 32% vs. 82%,
p
< 0.001), and lower rate of complications over Clavien–Dindo grade II (RPE vs. OPE: 48% vs. 74%,
p
= 0.013; RPE vs. LPE: 48% vs. 76%,
p
= 0.002).
Conclusion
This multicenter study suggests that RPE reduces blood loss and transfusion compared with OPE and has a lower rate of complications compared with OPE and LPE in patients with locally advanced and recurrent pelvic tumors.</description><identifier>ISSN: 0930-2794</identifier><identifier>ISSN: 1432-2218</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-024-10966-w</identifier><identifier>PMID: 38886231</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Blood Loss, Surgical - statistics & numerical data ; Blood Transfusion - statistics & numerical data ; Clinical medicine ; Clinical practice guidelines ; Colorectal cancer ; Endoscopy ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Japan ; Laparoscopy ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Morbidity ; Mortality ; Operative Time ; Patients ; Pelvic Exenteration - methods ; Pelvic Neoplasms - surgery ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Proctology ; Propensity Score ; Rectum ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - methods ; Surgery ; Surgical outcomes ; Treatment Outcome ; Tumors</subject><ispartof>Surgical endoscopy, 2024-08, Vol.38 (8), p.4390-4401</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-79865ca79f53a42beeb6d86f88f0cadb4c1c908ada98481a1dfcb3477ecdab6c3</cites><orcidid>0000-0002-7885-2276</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/s00464-024-10966-w$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-024-10966-w$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38886231$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yatabe, Yusuke</creatorcontrib><creatorcontrib>Hanaoka, Marie</creatorcontrib><creatorcontrib>Hanazawa, Ryoichi</creatorcontrib><creatorcontrib>Hirakawa, Akihiro</creatorcontrib><creatorcontrib>Mukai, Toshiki</creatorcontrib><creatorcontrib>Kimura, Kei</creatorcontrib><creatorcontrib>Yamanoi, Koji</creatorcontrib><creatorcontrib>Kono, Jin</creatorcontrib><creatorcontrib>Yokota, Mitsuru</creatorcontrib><creatorcontrib>Takahashi, Hiroki</creatorcontrib><creatorcontrib>Kobayashi, Akihiro</creatorcontrib><creatorcontrib>Kobayashi, Kenji</creatorcontrib><creatorcontrib>Ichikawa, Nobuki</creatorcontrib><creatorcontrib>Yasui, Masayoshi</creatorcontrib><creatorcontrib>Nakane, Keita</creatorcontrib><creatorcontrib>Yamamoto, Manabu</creatorcontrib><creatorcontrib>Takenaka, Atsushi</creatorcontrib><creatorcontrib>Nakamura, Yuya</creatorcontrib><creatorcontrib>Takemasa, Ichiro</creatorcontrib><creatorcontrib>Yabusaki, Norimitsu</creatorcontrib><creatorcontrib>Akamoto, Shintaro</creatorcontrib><creatorcontrib>Tatarano, Shuichi</creatorcontrib><creatorcontrib>Murata, Kohei</creatorcontrib><creatorcontrib>Manabe, Tatsuya</creatorcontrib><creatorcontrib>Fujimura, Tetsuya</creatorcontrib><creatorcontrib>Kawamura, Mikio</creatorcontrib><creatorcontrib>Egi, Hiroyuki</creatorcontrib><creatorcontrib>Yamaguchi, Shigeki</creatorcontrib><creatorcontrib>Terai, Yoshito</creatorcontrib><creatorcontrib>Inoue, Shigetaka</creatorcontrib><creatorcontrib>Ito, Akihiro</creatorcontrib><creatorcontrib>Kinugasa, Yusuke</creatorcontrib><title>Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This study aimed to evaluate the safety and efficacy of robot-assisted PE (RPE) by comparing the outcomes of open PE (OPE) with those of conventional laparoscopic PE (LPE) for treating pelvic tumors.
Methods
Following the ethics committee approval, a multicenter retrospective analysis of patients who underwent pelvic exenteration between January 2012 and October 2022 was conducted. Data on patient demographics, tumor characteristics, and perioperative outcomes were collected. A 1:1 propensity score-matched analysis was performed to minimize group selection bias.
Results
In total, 261 patients met the study criteria, of whom 61 underwent RPE, 90 underwent OPE, and 110 underwent LPE. After propensity score matching, 50 pairs were created for RPE and OPE and 59 for RPE and LPE. RPE was associated with significantly less blood loss (RPE vs. OPE: 408 mL vs. 2385 ml,
p
< 0.001), lower transfusion rate (RPE vs. OPE: 32% vs. 82%,
p
< 0.001), and lower rate of complications over Clavien–Dindo grade II (RPE vs. OPE: 48% vs. 74%,
p
= 0.013; RPE vs. LPE: 48% vs. 76%,
p
= 0.002).
Conclusion
This multicenter study suggests that RPE reduces blood loss and transfusion compared with OPE and has a lower rate of complications compared with OPE and LPE in patients with locally advanced and recurrent pelvic tumors.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Clinical medicine</subject><subject>Clinical practice guidelines</subject><subject>Colorectal cancer</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Japan</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Operative Time</subject><subject>Patients</subject><subject>Pelvic Exenteration - methods</subject><subject>Pelvic Neoplasms - surgery</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Propensity Score</subject><subject>Rectum</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0930-2794</issn><issn>1432-2218</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv1TAQRi0EopfCH2CBLLFhY_Arjs0OVeWlSkgI1tbEmUCqxA520nJX_HV8e1uQWLCwZjFnzoz8EfJU8JeC8_ZV4VwbzbjUTHBnDLu-R3ZCK8mkFPY-2XGnOJOt0yfkUSmXvPJONA_JibLWGqnEjvz6nLq0joFeYS5boWnBSCH2dIIFciohLbW54HRVC_7EuGKGdUyx0CHlu0aAGDC_pkDnbaq2G4wu-WAr47pnM6zhO_bVDNO-jIWOkX6sG-Jj8mCAqeCT23pKvr49_3L2nl18evfh7M0FC7IxK2udNU2A1g2NAi07xM701gzWDjxA3-kgguMWenBWWwGiH0KndNti6KEzQZ2SF0dvPerHhmX181gCThNETFvxire8dcpoWdHn_6CXacv18ANljWhkfZWSRyrUXyoZB7_kcYa894L7Qzz-GI-v8fibePx1HXp2q966Gfs_I3d5VEAdgVJb8Rvmv7v_o_0NbkGe1w</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Yatabe, Yusuke</creator><creator>Hanaoka, Marie</creator><creator>Hanazawa, Ryoichi</creator><creator>Hirakawa, Akihiro</creator><creator>Mukai, Toshiki</creator><creator>Kimura, Kei</creator><creator>Yamanoi, Koji</creator><creator>Kono, Jin</creator><creator>Yokota, Mitsuru</creator><creator>Takahashi, Hiroki</creator><creator>Kobayashi, Akihiro</creator><creator>Kobayashi, Kenji</creator><creator>Ichikawa, Nobuki</creator><creator>Yasui, Masayoshi</creator><creator>Nakane, Keita</creator><creator>Yamamoto, Manabu</creator><creator>Takenaka, Atsushi</creator><creator>Nakamura, Yuya</creator><creator>Takemasa, Ichiro</creator><creator>Yabusaki, Norimitsu</creator><creator>Akamoto, Shintaro</creator><creator>Tatarano, Shuichi</creator><creator>Murata, Kohei</creator><creator>Manabe, Tatsuya</creator><creator>Fujimura, Tetsuya</creator><creator>Kawamura, Mikio</creator><creator>Egi, Hiroyuki</creator><creator>Yamaguchi, Shigeki</creator><creator>Terai, Yoshito</creator><creator>Inoue, Shigetaka</creator><creator>Ito, Akihiro</creator><creator>Kinugasa, Yusuke</creator><general>Springer US</general><general>Springer Nature B.V</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>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7885-2276</orcidid></search><sort><creationdate>20240801</creationdate><title>Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan</title><author>Yatabe, Yusuke ; Hanaoka, Marie ; Hanazawa, Ryoichi ; Hirakawa, Akihiro ; Mukai, Toshiki ; Kimura, Kei ; Yamanoi, Koji ; Kono, Jin ; Yokota, Mitsuru ; Takahashi, Hiroki ; Kobayashi, Akihiro ; Kobayashi, Kenji ; Ichikawa, Nobuki ; Yasui, Masayoshi ; Nakane, Keita ; Yamamoto, Manabu ; Takenaka, Atsushi ; Nakamura, Yuya ; Takemasa, Ichiro ; Yabusaki, Norimitsu ; Akamoto, Shintaro ; Tatarano, Shuichi ; Murata, Kohei ; Manabe, Tatsuya ; Fujimura, Tetsuya ; Kawamura, Mikio ; Egi, Hiroyuki ; Yamaguchi, Shigeki ; Terai, Yoshito ; Inoue, Shigetaka ; Ito, Akihiro ; Kinugasa, Yusuke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-79865ca79f53a42beeb6d86f88f0cadb4c1c908ada98481a1dfcb3477ecdab6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Blood Transfusion - statistics & numerical data</topic><topic>Clinical medicine</topic><topic>Clinical practice guidelines</topic><topic>Colorectal cancer</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Japan</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Operative Time</topic><topic>Patients</topic><topic>Pelvic Exenteration - methods</topic><topic>Pelvic Neoplasms - surgery</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Propensity Score</topic><topic>Rectum</topic><topic>Retrospective Studies</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yatabe, Yusuke</creatorcontrib><creatorcontrib>Hanaoka, Marie</creatorcontrib><creatorcontrib>Hanazawa, Ryoichi</creatorcontrib><creatorcontrib>Hirakawa, Akihiro</creatorcontrib><creatorcontrib>Mukai, Toshiki</creatorcontrib><creatorcontrib>Kimura, Kei</creatorcontrib><creatorcontrib>Yamanoi, Koji</creatorcontrib><creatorcontrib>Kono, Jin</creatorcontrib><creatorcontrib>Yokota, Mitsuru</creatorcontrib><creatorcontrib>Takahashi, Hiroki</creatorcontrib><creatorcontrib>Kobayashi, Akihiro</creatorcontrib><creatorcontrib>Kobayashi, Kenji</creatorcontrib><creatorcontrib>Ichikawa, Nobuki</creatorcontrib><creatorcontrib>Yasui, Masayoshi</creatorcontrib><creatorcontrib>Nakane, Keita</creatorcontrib><creatorcontrib>Yamamoto, Manabu</creatorcontrib><creatorcontrib>Takenaka, Atsushi</creatorcontrib><creatorcontrib>Nakamura, Yuya</creatorcontrib><creatorcontrib>Takemasa, Ichiro</creatorcontrib><creatorcontrib>Yabusaki, Norimitsu</creatorcontrib><creatorcontrib>Akamoto, Shintaro</creatorcontrib><creatorcontrib>Tatarano, Shuichi</creatorcontrib><creatorcontrib>Murata, Kohei</creatorcontrib><creatorcontrib>Manabe, Tatsuya</creatorcontrib><creatorcontrib>Fujimura, Tetsuya</creatorcontrib><creatorcontrib>Kawamura, Mikio</creatorcontrib><creatorcontrib>Egi, Hiroyuki</creatorcontrib><creatorcontrib>Yamaguchi, Shigeki</creatorcontrib><creatorcontrib>Terai, Yoshito</creatorcontrib><creatorcontrib>Inoue, Shigetaka</creatorcontrib><creatorcontrib>Ito, Akihiro</creatorcontrib><creatorcontrib>Kinugasa, Yusuke</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yatabe, Yusuke</au><au>Hanaoka, Marie</au><au>Hanazawa, Ryoichi</au><au>Hirakawa, Akihiro</au><au>Mukai, Toshiki</au><au>Kimura, Kei</au><au>Yamanoi, Koji</au><au>Kono, Jin</au><au>Yokota, Mitsuru</au><au>Takahashi, Hiroki</au><au>Kobayashi, Akihiro</au><au>Kobayashi, Kenji</au><au>Ichikawa, Nobuki</au><au>Yasui, Masayoshi</au><au>Nakane, Keita</au><au>Yamamoto, Manabu</au><au>Takenaka, Atsushi</au><au>Nakamura, Yuya</au><au>Takemasa, Ichiro</au><au>Yabusaki, Norimitsu</au><au>Akamoto, Shintaro</au><au>Tatarano, Shuichi</au><au>Murata, Kohei</au><au>Manabe, Tatsuya</au><au>Fujimura, Tetsuya</au><au>Kawamura, Mikio</au><au>Egi, Hiroyuki</au><au>Yamaguchi, Shigeki</au><au>Terai, Yoshito</au><au>Inoue, Shigetaka</au><au>Ito, Akihiro</au><au>Kinugasa, Yusuke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>38</volume><issue>8</issue><spage>4390</spage><epage>4401</epage><pages>4390-4401</pages><issn>0930-2794</issn><issn>1432-2218</issn><eissn>1432-2218</eissn><abstract>Background
Pelvic exenteration (PE) is the last resort for achieving a complete cure for pelvic cancer; however, it is burdensome for patients. Minimally invasive surgeries, including robot-assisted surgery, have been widely used to treat malignant tumors and have also recently been used in PE. This study aimed to evaluate the safety and efficacy of robot-assisted PE (RPE) by comparing the outcomes of open PE (OPE) with those of conventional laparoscopic PE (LPE) for treating pelvic tumors.
Methods
Following the ethics committee approval, a multicenter retrospective analysis of patients who underwent pelvic exenteration between January 2012 and October 2022 was conducted. Data on patient demographics, tumor characteristics, and perioperative outcomes were collected. A 1:1 propensity score-matched analysis was performed to minimize group selection bias.
Results
In total, 261 patients met the study criteria, of whom 61 underwent RPE, 90 underwent OPE, and 110 underwent LPE. After propensity score matching, 50 pairs were created for RPE and OPE and 59 for RPE and LPE. RPE was associated with significantly less blood loss (RPE vs. OPE: 408 mL vs. 2385 ml,
p
< 0.001), lower transfusion rate (RPE vs. OPE: 32% vs. 82%,
p
< 0.001), and lower rate of complications over Clavien–Dindo grade II (RPE vs. OPE: 48% vs. 74%,
p
= 0.013; RPE vs. LPE: 48% vs. 76%,
p
= 0.002).
Conclusion
This multicenter study suggests that RPE reduces blood loss and transfusion compared with OPE and has a lower rate of complications compared with OPE and LPE in patients with locally advanced and recurrent pelvic tumors.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>38886231</pmid><doi>10.1007/s00464-024-10966-w</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-7885-2276</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2024-08, Vol.38 (8), p.4390-4401 |
| issn | 0930-2794 1432-2218 1432-2218 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3070793642 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adult Aged Blood Loss, Surgical - statistics & numerical data Blood Transfusion - statistics & numerical data Clinical medicine Clinical practice guidelines Colorectal cancer Endoscopy Female Gastroenterology Gynecology Hepatology Humans Japan Laparoscopy Laparoscopy - methods Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Morbidity Mortality Operative Time Patients Pelvic Exenteration - methods Pelvic Neoplasms - surgery Postoperative Complications - epidemiology Postoperative Complications - etiology Proctology Propensity Score Rectum Retrospective Studies Robotic surgery Robotic Surgical Procedures - methods Surgery Surgical outcomes Treatment Outcome Tumors |
| title | Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan |
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