Is Robotic-Assisted Surgery Safe in the Elderly Population? An Analysis of Gynecologic Procedures in Patients 65Years Old

被引:19
作者
Aloisi, Alessia [1 ]
Tseng, Jill H. [1 ]
Sandadi, Samith [1 ]
Callery, Ryan [1 ]
Feinberg, Jacqueline [2 ]
Kuhn, Theresa [3 ]
Gardner, Ginger J. [1 ,4 ]
Sonoda, Yukio [1 ,4 ]
Brown, Carol L. [1 ,4 ]
Jewell, Elizabeth L. [1 ,4 ]
Barakat, Richard R. [1 ,5 ,6 ]
Leitao, Mario M., Jr. [1 ,4 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Gynecol Serv, 1275 York Ave, New York, NY 10021 USA
[2] Yale Sch Med, New Haven, CT USA
[3] Rutgers New Jersey Med Sch, Newark, NJ USA
[4] Weill Cornell Med Coll, New York, NY 10065 USA
[5] Northwell Hlth Canc Inst, New Hyde Pk, NY USA
[6] Hofstra Univ, Zucker Sch Med, Hempstead, NY 11550 USA
关键词
ENDOMETRIAL CANCER; PERIOPERATIVE OUTCOMES; LAPAROSCOPIC HYSTERECTOMY; UTERINE-CANCER; RISK-FACTORS; LAPAROTOMY; SURVIVAL; IMPACT; AGE; COMPLICATIONS;
D O I
10.1245/s10434-018-6997-1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundThe elderly population is expanding worldwide but is underrepresented in clinical trials. We sought to assess the safety of robotic gynecologic surgery in an elderly cohort and to identify factors associated with unfavorable outcomes.MethodsAll patients65years who underwent a robotically assisted procedure at a single institution between May 2007 to December 2016 were divided into three age groups: 65-74 (Group 1); 75-84 (Group 2);85 (Group 3). Perioperative outcomes were recorded in patients who did not require conversion to laparotomy. We compared clinical variables among groups and performed multivariate logistic regression to detect variables associated with major complications (Grade 3) or 90-day mortality.ResultsWe retrospectively identified 982 cases: 685 in Group 1; 249 in Group 2; 48 in Group 3. Median age=71years. Median BMI=28.9. Malignancy was documented in 72.8% of cases; the majority were endometrial cancer (61.8%). Thirty-four patients (3.5%) were readmitted within 30days. Seventy-seven (7.8%) had a postoperative complication, and 23 (2.3%) had a major complication. Ninety-day mortality was 0.5%. There was significant difference between groups with respect to body mass index (P=0.026), ECOG PS (P0.001),>5 comorbidities (P=0.005), hospital stay (P<0.001), major complications (P=0.001), and 90-day mortality (P<0.001). On multivariable logistic regression, age85years was associated with major complications. Body mass index, age85years, and major complications were significantly associated with 90-day mortality.ConclusionsRobotic-assisted surgery appears to be safe in an elderly cohort. The incidence of overall and major complications is consistent with those reported in the literature. Patients85years old appear to be at higher risk of unfavorable outcomes.
引用
收藏
页码:244 / 251
页数:8
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