Assessing robotic-assisted surgery versus open approach in penetrating Crohn’s disease: advantages and outcomes in ileocolic resection
Introduction Penetrating Crohn’s disease (CD) often necessitates surgical intervention, with the open approach traditionally favored. Robotic-assisted surgery offers potential benefits but remains understudied in this complex patient population. Additionally, the lack of standardized surgical comple...
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| Veröffentlicht in: | Techniques in coloproctology 2024-08, Vol.28 (1), p.112 |
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| creator | Violante, T. Ferrari, D. Sileo, A. Sassun, R. Ng, J. C. Mathis, K. L. McKenna, N. P. Rumer, K. K. Larson, D. W. |
| description | Introduction
Penetrating Crohn’s disease (CD) often necessitates surgical intervention, with the open approach traditionally favored. Robotic-assisted surgery offers potential benefits but remains understudied in this complex patient population. Additionally, the lack of standardized surgical complexity scoring in CD hinders research and comparisons.
Methods
We retrospectively analyzed adult patients with penetrating CD who underwent either robotic-assisted ileocolic resection (RICR) or open ileocolic resection (OICR) at our institution from January 2007 to December 2021. We assessed endpoints, including length of stay, complications, readmissions, reoperations, and other perioperative outcomes.
Results
RICR demonstrated safety outcomes comparable to OICR. Importantly, RICR patients experienced significantly reduced estimated blood loss (
p
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| doi_str_mv | 10.1007/s10151-024-02985-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_3095676805</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3095599203</sourcerecordid><originalsourceid>FETCH-LOGICAL-p213t-d68cd227848bbe30d99774c14256b0368d7bb5708984cbec01900b0d2b33f2223</originalsourceid><addsrcrecordid>eNpdkc9qFTEUxoNYbK2-gAsJuHEz9iSZTDLuysV_UOhGwd2QP6e3U-YmY85MoTuXvoKv55OY3lsRugjJR37n45zzMfZKwDsBYM5IgNCiAdnW01vd6CfsRAhpG2j196f7t2o6pcwxe050AyCM0eIZO1a96IyS7Qn7dU6ERGPa8pJ9XsbQuCppwchpLVssd_wWC63E84yJu3ku2YVrPiZeNS7FLffFm5Kv05-fv4nHkdARvucu3rq0uC0SdynyvC4h76qoleOEOeRpDLwgYVjGnF6woys3Eb58uE_Zt48fvm4-NxeXn75szi-aWQq1NLGzIUppbGu9RwWx741pg2il7jyozkbjvTZge9sGjwFED-AhSq_UlZRSnbK3B986x48VaRl2IwWcJpcwrzQo6HVnOgu6om8eoTd5Lal2t6d030tQlXr9QK1-h3GYy7hz5W74t-MKqANA9SvVjf63ETDcJzkckhxqksM-yUGrv7QBkSw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3095599203</pqid></control><display><type>article</type><title>Assessing robotic-assisted surgery versus open approach in penetrating Crohn’s disease: advantages and outcomes in ileocolic resection</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Violante, T. ; Ferrari, D. ; Sileo, A. ; Sassun, R. ; Ng, J. C. ; Mathis, K. L. ; McKenna, N. P. ; Rumer, K. K. ; Larson, D. W.</creator><creatorcontrib>Violante, T. ; Ferrari, D. ; Sileo, A. ; Sassun, R. ; Ng, J. C. ; Mathis, K. L. ; McKenna, N. P. ; Rumer, K. K. ; Larson, D. W.</creatorcontrib><description>Introduction
Penetrating Crohn’s disease (CD) often necessitates surgical intervention, with the open approach traditionally favored. Robotic-assisted surgery offers potential benefits but remains understudied in this complex patient population. Additionally, the lack of standardized surgical complexity scoring in CD hinders research and comparisons.
Methods
We retrospectively analyzed adult patients with penetrating CD who underwent either robotic-assisted ileocolic resection (RICR) or open ileocolic resection (OICR) at our institution from January 2007 to December 2021. We assessed endpoints, including length of stay, complications, readmissions, reoperations, and other perioperative outcomes.
Results
RICR demonstrated safety outcomes comparable to OICR. Importantly, RICR patients experienced significantly reduced estimated blood loss (
p
< 0.0001), shorter hospital stays (median 4.5 days versus 6.9 days;
p
= 0.01), lower surgical site infection rates (0% versus 15.4%;
p
= 0.01), and decreased 30-day readmission rates (0% versus 15.4%;
p
= 0.01). Linear regression analysis revealed the need for additional strictureplasties (coefficient: 84.8;
p
= 0.008), colonic resections (coefficient: 41.7;
p
= 0.008), and estimated blood loss (coefficient: 0.07;
p
= 0.002) independently correlated with longer operative times).
Conclusion
Robotic-assisted surgery appears to be a safe and potentially beneficial alternative for the surgical management of penetrating CD, offering advantages in perioperative outcomes reducing length of stay, blood loss, surgical site infection rates, and readmission rates. Further validation with larger cohorts is warranted.</description><identifier>ISSN: 1123-6337</identifier><identifier>ISSN: 1128-045X</identifier><identifier>EISSN: 1128-045X</identifier><identifier>DOI: 10.1007/s10151-024-02985-5</identifier><identifier>PMID: 39167324</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject><![CDATA[Abdominal Surgery ; Adult ; Blood Loss, Surgical - statistics & numerical data ; Colectomy - adverse effects ; Colectomy - methods ; Colon - surgery ; Colorectal Surgery ; Crohn Disease - surgery ; Crohn's disease ; Female ; Fistula ; Gastroenterology ; Humans ; Ileum - surgery ; Length of stay ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Patient Readmission - statistics & numerical data ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Proctology ; Reoperation - methods ; Reoperation - statistics & numerical data ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Robotic Surgical Procedures - statistics & numerical data ; Surgery ; Surgical outcomes ; Surgical site infections ; Treatment Outcome]]></subject><ispartof>Techniques in coloproctology, 2024-08, Vol.28 (1), p.112</ispartof><rights>Springer Nature Switzerland AG 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. Springer Nature Switzerland AG.</rights><rights>Copyright Springer Nature B.V. 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10151-024-02985-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10151-024-02985-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39167324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Violante, T.</creatorcontrib><creatorcontrib>Ferrari, D.</creatorcontrib><creatorcontrib>Sileo, A.</creatorcontrib><creatorcontrib>Sassun, R.</creatorcontrib><creatorcontrib>Ng, J. C.</creatorcontrib><creatorcontrib>Mathis, K. L.</creatorcontrib><creatorcontrib>McKenna, N. P.</creatorcontrib><creatorcontrib>Rumer, K. K.</creatorcontrib><creatorcontrib>Larson, D. W.</creatorcontrib><title>Assessing robotic-assisted surgery versus open approach in penetrating Crohn’s disease: advantages and outcomes in ileocolic resection</title><title>Techniques in coloproctology</title><addtitle>Tech Coloproctol</addtitle><addtitle>Tech Coloproctol</addtitle><description>Introduction
Penetrating Crohn’s disease (CD) often necessitates surgical intervention, with the open approach traditionally favored. Robotic-assisted surgery offers potential benefits but remains understudied in this complex patient population. Additionally, the lack of standardized surgical complexity scoring in CD hinders research and comparisons.
Methods
We retrospectively analyzed adult patients with penetrating CD who underwent either robotic-assisted ileocolic resection (RICR) or open ileocolic resection (OICR) at our institution from January 2007 to December 2021. We assessed endpoints, including length of stay, complications, readmissions, reoperations, and other perioperative outcomes.
Results
RICR demonstrated safety outcomes comparable to OICR. Importantly, RICR patients experienced significantly reduced estimated blood loss (
p
< 0.0001), shorter hospital stays (median 4.5 days versus 6.9 days;
p
= 0.01), lower surgical site infection rates (0% versus 15.4%;
p
= 0.01), and decreased 30-day readmission rates (0% versus 15.4%;
p
= 0.01). Linear regression analysis revealed the need for additional strictureplasties (coefficient: 84.8;
p
= 0.008), colonic resections (coefficient: 41.7;
p
= 0.008), and estimated blood loss (coefficient: 0.07;
p
= 0.002) independently correlated with longer operative times).
Conclusion
Robotic-assisted surgery appears to be a safe and potentially beneficial alternative for the surgical management of penetrating CD, offering advantages in perioperative outcomes reducing length of stay, blood loss, surgical site infection rates, and readmission rates. Further validation with larger cohorts is warranted.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Colectomy - adverse effects</subject><subject>Colectomy - methods</subject><subject>Colon - surgery</subject><subject>Colorectal Surgery</subject><subject>Crohn Disease - surgery</subject><subject>Crohn's disease</subject><subject>Female</subject><subject>Fistula</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Ileum - surgery</subject><subject>Length of stay</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>Original Article</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Proctology</subject><subject>Reoperation - methods</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotic Surgical Procedures - statistics & numerical data</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical site infections</subject><subject>Treatment Outcome</subject><issn>1123-6337</issn><issn>1128-045X</issn><issn>1128-045X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc9qFTEUxoNYbK2-gAsJuHEz9iSZTDLuysV_UOhGwd2QP6e3U-YmY85MoTuXvoKv55OY3lsRugjJR37n45zzMfZKwDsBYM5IgNCiAdnW01vd6CfsRAhpG2j196f7t2o6pcwxe050AyCM0eIZO1a96IyS7Qn7dU6ERGPa8pJ9XsbQuCppwchpLVssd_wWC63E84yJu3ku2YVrPiZeNS7FLffFm5Kv05-fv4nHkdARvucu3rq0uC0SdynyvC4h76qoleOEOeRpDLwgYVjGnF6woys3Eb58uE_Zt48fvm4-NxeXn75szi-aWQq1NLGzIUppbGu9RwWx741pg2il7jyozkbjvTZge9sGjwFED-AhSq_UlZRSnbK3B986x48VaRl2IwWcJpcwrzQo6HVnOgu6om8eoTd5Lal2t6d030tQlXr9QK1-h3GYy7hz5W74t-MKqANA9SvVjf63ETDcJzkckhxqksM-yUGrv7QBkSw</recordid><startdate>20240821</startdate><enddate>20240821</enddate><creator>Violante, T.</creator><creator>Ferrari, D.</creator><creator>Sileo, A.</creator><creator>Sassun, R.</creator><creator>Ng, J. C.</creator><creator>Mathis, K. L.</creator><creator>McKenna, N. P.</creator><creator>Rumer, K. K.</creator><creator>Larson, D. W.</creator><general>Springer International Publishing</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>K9.</scope><scope>7X8</scope></search><sort><creationdate>20240821</creationdate><title>Assessing robotic-assisted surgery versus open approach in penetrating Crohn’s disease: advantages and outcomes in ileocolic resection</title><author>Violante, T. ; Ferrari, D. ; Sileo, A. ; Sassun, R. ; Ng, J. C. ; Mathis, K. L. ; McKenna, N. P. ; Rumer, K. K. ; Larson, D. W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p213t-d68cd227848bbe30d99774c14256b0368d7bb5708984cbec01900b0d2b33f2223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Colectomy - adverse effects</topic><topic>Colectomy - methods</topic><topic>Colon - surgery</topic><topic>Colorectal Surgery</topic><topic>Crohn Disease - surgery</topic><topic>Crohn's disease</topic><topic>Female</topic><topic>Fistula</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Ileum - surgery</topic><topic>Length of stay</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>Original Article</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Proctology</topic><topic>Reoperation - methods</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotic Surgical Procedures - statistics & numerical data</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical site infections</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Violante, T.</creatorcontrib><creatorcontrib>Ferrari, D.</creatorcontrib><creatorcontrib>Sileo, A.</creatorcontrib><creatorcontrib>Sassun, R.</creatorcontrib><creatorcontrib>Ng, J. C.</creatorcontrib><creatorcontrib>Mathis, K. L.</creatorcontrib><creatorcontrib>McKenna, N. P.</creatorcontrib><creatorcontrib>Rumer, K. K.</creatorcontrib><creatorcontrib>Larson, D. W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Techniques in coloproctology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Violante, T.</au><au>Ferrari, D.</au><au>Sileo, A.</au><au>Sassun, R.</au><au>Ng, J. C.</au><au>Mathis, K. L.</au><au>McKenna, N. P.</au><au>Rumer, K. K.</au><au>Larson, D. W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing robotic-assisted surgery versus open approach in penetrating Crohn’s disease: advantages and outcomes in ileocolic resection</atitle><jtitle>Techniques in coloproctology</jtitle><stitle>Tech Coloproctol</stitle><addtitle>Tech Coloproctol</addtitle><date>2024-08-21</date><risdate>2024</risdate><volume>28</volume><issue>1</issue><spage>112</spage><pages>112-</pages><issn>1123-6337</issn><issn>1128-045X</issn><eissn>1128-045X</eissn><abstract>Introduction
Penetrating Crohn’s disease (CD) often necessitates surgical intervention, with the open approach traditionally favored. Robotic-assisted surgery offers potential benefits but remains understudied in this complex patient population. Additionally, the lack of standardized surgical complexity scoring in CD hinders research and comparisons.
Methods
We retrospectively analyzed adult patients with penetrating CD who underwent either robotic-assisted ileocolic resection (RICR) or open ileocolic resection (OICR) at our institution from January 2007 to December 2021. We assessed endpoints, including length of stay, complications, readmissions, reoperations, and other perioperative outcomes.
Results
RICR demonstrated safety outcomes comparable to OICR. Importantly, RICR patients experienced significantly reduced estimated blood loss (
p
< 0.0001), shorter hospital stays (median 4.5 days versus 6.9 days;
p
= 0.01), lower surgical site infection rates (0% versus 15.4%;
p
= 0.01), and decreased 30-day readmission rates (0% versus 15.4%;
p
= 0.01). Linear regression analysis revealed the need for additional strictureplasties (coefficient: 84.8;
p
= 0.008), colonic resections (coefficient: 41.7;
p
= 0.008), and estimated blood loss (coefficient: 0.07;
p
= 0.002) independently correlated with longer operative times).
Conclusion
Robotic-assisted surgery appears to be a safe and potentially beneficial alternative for the surgical management of penetrating CD, offering advantages in perioperative outcomes reducing length of stay, blood loss, surgical site infection rates, and readmission rates. Further validation with larger cohorts is warranted.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>39167324</pmid><doi>10.1007/s10151-024-02985-5</doi></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Adult Blood Loss, Surgical - statistics & numerical data Colectomy - adverse effects Colectomy - methods Colon - surgery Colorectal Surgery Crohn Disease - surgery Crohn's disease Female Fistula Gastroenterology Humans Ileum - surgery Length of stay Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Middle Aged Original Article Patient Readmission - statistics & numerical data Postoperative Complications - epidemiology Postoperative Complications - etiology Proctology Reoperation - methods Reoperation - statistics & numerical data Retrospective Studies Robotic surgery Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Robotic Surgical Procedures - statistics & numerical data Surgery Surgical outcomes Surgical site infections Treatment Outcome |
| title | Assessing robotic-assisted surgery versus open approach in penetrating Crohn’s disease: advantages and outcomes in ileocolic resection |
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