Abstract：
OBJECTIVE: Robotic assisted surgery is an alternative, fast evolving technique for performing colorectal surgery. The primary aim of this single center analysis is to compare elective laparoscopic and robotic sigmoid colectomies for diverticular disease on the extent of operative trauma and the costs.
METHODS: Retrospective analysis from our prospective clinical database to identify all consecutive patients aged ≥ 18 years who underwent elective minimally invasive left sided colectomy for diverticular disease from January 2016 until December 2020 at our tertiary referral institution.
RESULTS: In total, 83 patients (31 female and 52 male) with sigmoid diverticulitis underwent elective minimally invasive sigmoid colectomy, of which 42 underwent conventional laparoscopic surgery (LS) and 41 robotic assisted surgery (RS). The mean C-reactive protein difference between the preoperative and postoperative value was significantly lower in the robotic assisted group (4,03 mg/dL) than in the laparoscopic group (7.32 mg/dL) (p = 0.030). Similarly, the robotic´s hemoglobin difference was significantly lower (p = 0.039). The first postoperative bowel movement in the LS group occurred after a mean of 2.19 days, later than after a mean of 1.63 days in the RS group (p = 0.011). An overview of overall charge revealed significantly lower total costs per operation and postoperative hospital stay for the robotic approach, 6058 € vs. 6142 € (p = 0,014) not including the acquisition and maintenance costs for both systems.
CONCLUSIONS: Robotic colon resection for diverticular disease is cost-effective and delivers reduced intraoperative trauma with significantly lower postoperative C-reactive protein and hemoglobin drift compared to conventional laparoscopy.
METHODS: Retrospective analysis from our prospective clinical database to identify all consecutive patients aged ≥ 18 years who underwent elective minimally invasive left sided colectomy for diverticular disease from January 2016 until December 2020 at our tertiary referral institution.
RESULTS: In total, 83 patients (31 female and 52 male) with sigmoid diverticulitis underwent elective minimally invasive sigmoid colectomy, of which 42 underwent conventional laparoscopic surgery (LS) and 41 robotic assisted surgery (RS). The mean C-reactive protein difference between the preoperative and postoperative value was significantly lower in the robotic assisted group (4,03 mg/dL) than in the laparoscopic group (7.32 mg/dL) (p = 0.030). Similarly, the robotic´s hemoglobin difference was significantly lower (p = 0.039). The first postoperative bowel movement in the LS group occurred after a mean of 2.19 days, later than after a mean of 1.63 days in the RS group (p = 0.011). An overview of overall charge revealed significantly lower total costs per operation and postoperative hospital stay for the robotic approach, 6058 € vs. 6142 € (p = 0,014) not including the acquisition and maintenance costs for both systems.
CONCLUSIONS: Robotic colon resection for diverticular disease is cost-effective and delivers reduced intraoperative trauma with significantly lower postoperative C-reactive protein and hemoglobin drift compared to conventional laparoscopy.
摘要：
目的：机器人辅助手术是一种选择，进行结直肠手术的快速发展技术。此单中心分析的主要目的是比较选择性腹腔镜和机器人乙状结肠切除术治疗憩室疾病的手术创伤程度和费用。
方法：从我们的前瞻性临床数据库中进行回顾性分析，以确定2016年1月至2020年12月在我们的三级转诊机构接受择期微创左侧结肠憩室切除术的所有年龄≥18岁的患者。
结果：总计，83例(女31例,男52例)乙状结肠憩室炎患者行选择性微创乙状结肠切除术,其中42例接受了传统腹腔镜手术（LS）和41例机器人辅助手术（RS）。机器人辅助组（4,03mg/dL）术前和术后的平均C反应蛋白差异显着低于腹腔镜组（7.32mg/dL）（p=0.030）。同样，机器人的血红蛋白差异显著较低(p=0.039).LS组术后第一次排便发生在平均2.19天后，RS组的平均1.63天后（p=0.011）。总体费用的概述显示，机器人方法的每次手术和术后住院时间的总成本显着降低。6058€vs.6142€（p=0.014），不包括两个系统的购置和维护成本。
结论：机器人结肠切除术治疗憩室病具有成本效益，与传统腹腔镜相比，术中创伤减少，术后C反应蛋白和血红蛋白漂移显著降低。
方法：从我们的前瞻性临床数据库中进行回顾性分析，以确定2016年1月至2020年12月在我们的三级转诊机构接受择期微创左侧结肠憩室切除术的所有年龄≥18岁的患者。
结果：总计，83例(女31例,男52例)乙状结肠憩室炎患者行选择性微创乙状结肠切除术,其中42例接受了传统腹腔镜手术（LS）和41例机器人辅助手术（RS）。机器人辅助组（4,03mg/dL）术前和术后的平均C反应蛋白差异显着低于腹腔镜组（7.32mg/dL）（p=0.030）。同样，机器人的血红蛋白差异显著较低(p=0.039).LS组术后第一次排便发生在平均2.19天后，RS组的平均1.63天后（p=0.011）。总体费用的概述显示，机器人方法的每次手术和术后住院时间的总成本显着降低。6058€vs.6142€（p=0.014），不包括两个系统的购置和维护成本。
结论：机器人结肠切除术治疗憩室病具有成本效益，与传统腹腔镜相比，术中创伤减少，术后C反应蛋白和血红蛋白漂移显著降低。
