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01-06-2018 | Original Article

The effect of obesity on laparoscopic and robotic-assisted colorectal surgery outcomes: an ACS-NSQIP database analysis

Authors: Jeffrey N. Harr, Ivy N. Haskins, Richard L. Amdur, Samir Agarwal, Vincent Obias

Published in: Journal of Robotic Surgery | Issue 2/2018

Abstract

Advantages of robotic-assisted colorectal surgery have been reported, but the effect on outcomes between obese and non-obese patients undergoing laparoscopic and robotic-assisted colorectal surgery remains unclear. Patients who underwent elective laparoscopic and robotic colon or rectal resections between 2012 and 2014 were identified in the ACS-NSQIP database. Propensity score matching was performed to determine the effect of obesity on laparoscopic and robotic-assisted 30-day surgical outcomes. 29,172 patients met inclusion criteria; 27,693 (94.9%) underwent laparoscopic colorectal surgery while 1479 (5.1%) underwent robotic-assisted surgery. Mean BMI was 28.4 kg/m² and 35% of patients had a BMI ≥30 kg/m². A 10-to-1 propensity matching of laparoscopic to robotic approaches was performed, resulting in 14,770 (90.9%) laparoscopic patients and 1477 (9.1%) robotic-assisted patients available for analysis. Robotic-assisted surgery was associated with lower conversion to laparotomy (2.4 vs 3.4%; p = 0.04) and decreased length-of-stay (4.5±3.2 vs 5.1±4.5 days; p < 0.0001). After adjusting for BMI and surgical approach, obese patients undergoing robotic-assisted surgery had a reduced odds ratio for developing prolonged ileus (p = 0.03). Robotic-assisted colorectal surgery is associated with fewer conversions to laparotomy and shorter length-of-stays compared to laparoscopic surgery. Risk of prolonged ileus is significantly reduced in obese patients undergoing a robotic-assisted approach.

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Title: The effect of obesity on laparoscopic and robotic-assisted colorectal surgery outcomes: an ACS-NSQIP database analysis
Authors: Jeffrey N. Harr
Ivy N. Haskins
Richard L. Amdur
Samir Agarwal
Vincent Obias
Publication date: 01-06-2018
Publisher: Springer London
Published in: Journal of Robotic Surgery / Issue 2/2018
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-017-0736-7

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