Intracorporeal Versus Extracorporeal Anastomosis in Robotic Right Colectomy A Multicenter, Triple-blind, Randomized Clinical Trial

被引：27

作者：

Dohrn, Niclas ^{[1
,2
]}

Yikilmaz, Helin ^{[2
]}

Laursen, Magnus ^{[1
]}

Khesrawi, Faisal ^{[2
]}

Clausen, Frederik Bjerg ^{[1
]}

Sorensen, Frederik ^{[3
]}

Jakobsen, Henrik Loft ^{[1
]}

Brisling, Steffen ^{[2
]}

Lykke, Jakob ^{[1
]}

Eriksen, Jens Ravn ^{[2
]}

Klein, Mads Falk ^{[1
]}

Gogenur, Ismail ^{[2
]}

机构：

[1] Copenhagen Univ Hosp Herlev & Gentofte, Dept Surg, Copenhagen, Denmark

[2] Zealand Univ Hosp Koege, Ctr Surg Sci, Koge, Denmark

[3] Univ Oxford, Dept Stat, Oxford, England

来源：

ANNALS OF SURGERY | 2022年 / 276卷 / 05期

基金：

美国国家卫生研究院; 英国惠康基金;

关键词：

enhanced recovery after surgery; intracorporeal anastomosis; minimally invasive surgery; patient-related recovery; robotic right colectomy; surgical pathophysiology; POSTOPERATIVE QUALITY; IMPORTANT DIFFERENCE; COLORECTAL SURGERY; END-POINTS; RECOVERY; SCORE; CLASSIFICATION; COMPLICATIONS; DEFINITIONS;

D O I：

10.1097/SLA.0000000000005254

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: To determine if minimally invasive right colectomy with intra-corporeal anastomosis improves postoperative recovery compared to extra-corporeal anastomosis. Background: Previous trials have shown that intracorporeal anastomosis improves postoperative recovery; however, it has not yet been evaluated in a setting with optimized perioperative care or with patient-related outcome measures. Methods: This was a multicenter, triple-blind, randomized clinical trial at two high-volume colorectal centers with strict adherence to optimized perioperative care pathways. The patients underwent robotic right colectomy with either intracorporeal or extracorporeal anastomosis. The primary outcome was patient-reported postoperative recovery measured using the "Quality of Recovery-15" questionnaire. ClinicalTrials.gov NCT03130166. Results: A total of 89 patients were randomized and analyzed according to the "Intention-to-treat"-principle. We found no statistically significant differences in patient-reported recovery between the groups. Postoperative pain, nausea, time to ambulation, time to first passage of flatus/stool, length of hospital stay, and pathophysiological tests showed no differences either. The duration of time to create the anastomosis was significantly longer with intracorporeal anastomosis (17 vs 13 min, P = 0.003), while all other intraoperative, postoperative, and pathology variables showed no difference. Conclusion: There were no significant differences in postoperative recovery between the two groups.

引用

页码：E294 / E301

页数：8

共 37 条

[1] A propensity score-matched comparison of intracorporeal and extracorporeal techniques for robotic-assisted right colectomy in an Enhanced Recovery Pathway [J].