机器人护理成果 针对急性胆囊病理的项目
Shannon Greenberg1, Marc Abou Assali, Yanli Li
1From the Department of Surgery (S.G.), University of Indiana Medical Center, Indianapolis, Indiana; Division of Acute Care Surgery (M.A.A., K.M.), Loma Linda University Health, Loma Linda; Intuitive Surgical Inc. (Y.L., H.B., C.N.), Sunnyvale; and Division of Gastrointestinal and Minimally Invasive Surgery (E.W.), Loma Linda University Health, Loma Linda, California.
The journal of trauma and acute care surgery
|January 8, 2024
概括
针对急性胆囊病的机器人胆囊切除术减少了开放转换,但增加了次总程序. 并发症和成本仍然与腹腔镜手术相当,需要进一步调查.
科学领域:
- 最少侵入性的手术
- 手术技术 手术技术
- 胃肠道手术 胃肠道手术
背景情况:
- 机器人胆囊切除术在紧急情况下急性胆囊疾病的使用正在增加.
- 有限的临床证据存在,比较机器人与腹腔镜方法.
- 这项研究解决了对新出现的胆囊切除术的现实数据的需求.
研究的目的:
- 为了比较新兴机器人与腹腔镜胆囊切除术的结果.
- 评估转换率,并发症和成本.
- 为急性胆囊疾病的临床决策提供证据.
主要方法:
- 对一个大型现实世界数据库 (2020-2022) 分析新出现的胆囊切除术.
- 利用来自美国医院的电子健康记录数据.
- 使用多变量逻辑回归与逆概率治疗权重 (IPTW) 进行结果比较.
- 使用ICD-10和/或CPT代码定义的结果.
主要成果:
- 机器人胆囊切除术显著降低了转换为开放手术的几率 (OR 0.68).
- 机器人方法增加了亚总胆囊切除术的几率 (OR 1.64).
- 在手术部位感染,再入院,住院时间或死亡率方面没有发现显著差异.
- 机器人和腹腔镜组之间的医院费用是可比的.
结论:
- 机器人胆囊切除术为急性胆囊疾病提供了减少转换到开放手术的机会.
- 它与亚总胆囊切除术的增加率有关.
- 并发症概况和医院费用与腹腔镜胆囊切除术相似.
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