Perioperative outcomes and adverse events of robotic colorectal resections for inflammatory bowel disease: a systematic literature review
Author(s)
Type
Journal Article
Abstract
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult
patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed,
using the text “robotic(s)” AND (“inflammatory bowel disease” OR “Crohn’s” OR “Ulcerative Colitis”). Two investigators
screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were pre
-
sented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis. Primary
outcomes included mortality and postoperative complications. Secondary outcomes included readmission rate, length of stay,
conversion rate, procedure time, estimated blood loss and functional outcome. The tertiary outcome was cost-effectiveness.
Eight studies (3 case-matched observational studies, 4 case series and 1 case report) met the inclusion criteria. There was no
reported mortality. Overall, complications occurred in 81 patients (54%) including 30 (20%) Clavien-Dindo III–IV complica
-
tions. Mean length of stay was 8.6 days. Eleven cases (7.3%) were converted to open. The mean robotic operating time was
99 min out of a mean total operating time of 298.6 min. Thirty-two patients (24.7%) were readmitted. Functional outcomes
were comparable among robotic, laparoscopic and open approaches. Case-matched observational studies comparing robotic
to laparoscopic surgery revealed a significantly longer procedure time; however, conversion, complication, length of stay
and readmission rates were similar. The case-matched observational study comparing robotic to open surgery also revealed
a longer procedure time and a higher readmission rate; postoperative complication rates and length of stay were similar. No
studies compared cost-effectiveness between robotic and traditional approaches. Although robotic resections for inflamma
-
tory bowel disease are technically feasible, outcomes must be interpreted with caution due to low-quality studies.
patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed,
using the text “robotic(s)” AND (“inflammatory bowel disease” OR “Crohn’s” OR “Ulcerative Colitis”). Two investigators
screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were pre
-
sented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis. Primary
outcomes included mortality and postoperative complications. Secondary outcomes included readmission rate, length of stay,
conversion rate, procedure time, estimated blood loss and functional outcome. The tertiary outcome was cost-effectiveness.
Eight studies (3 case-matched observational studies, 4 case series and 1 case report) met the inclusion criteria. There was no
reported mortality. Overall, complications occurred in 81 patients (54%) including 30 (20%) Clavien-Dindo III–IV complica
-
tions. Mean length of stay was 8.6 days. Eleven cases (7.3%) were converted to open. The mean robotic operating time was
99 min out of a mean total operating time of 298.6 min. Thirty-two patients (24.7%) were readmitted. Functional outcomes
were comparable among robotic, laparoscopic and open approaches. Case-matched observational studies comparing robotic
to laparoscopic surgery revealed a significantly longer procedure time; however, conversion, complication, length of stay
and readmission rates were similar. The case-matched observational study comparing robotic to open surgery also revealed
a longer procedure time and a higher readmission rate; postoperative complication rates and length of stay were similar. No
studies compared cost-effectiveness between robotic and traditional approaches. Although robotic resections for inflamma
-
tory bowel disease are technically feasible, outcomes must be interpreted with caution due to low-quality studies.
Date Issued
2018-03-15
Date Acceptance
2018-02-05
Citation
TECHNIQUES IN COLOPROCTOLOGY, 2018, 22 (3), pp.161-177
ISSN
1123-6337
Publisher
SPRINGER-VERLAG ITALIA SRL
Start Page
161
End Page
177
Journal / Book Title
TECHNIQUES IN COLOPROCTOLOGY
Volume
22
Issue
3
Copyright Statement
© 2018 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000428057400002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Gastroenterology & Hepatology
Surgery
Inflammatory bowel disease
Colorectal resection
Robotic surgical procedures
POUCH-ANAL ANASTOMOSIS
LAPAROSCOPIC RESTORATIVE PROCTOCOLECTOMY
ULCERATIVE-COLITIS
LEARNING-CURVE
MULTIDIMENSIONAL-ANALYSIS
SURGERY
COLECTOMY
EXPERIENCE
COMPLICATIONS
METAANALYSIS
Publication Status
Published
Date Publish Online
2018-03-15