Robotic-assisted versus conventional laparoscopic approach in patients with large rectal endometriotic nodule: the evaluation of safety and complications.
Humans
Female
Digestive System Surgical Procedures
/ adverse effects
Endometriosis
/ surgery
Robotic Surgical Procedures
/ adverse effects
Retrospective Studies
Rectal Diseases
/ complications
Laparoscopy
/ adverse effects
Postoperative Complications
/ epidemiology
Anastomotic Leak
/ epidemiology
Fistula
/ complications
Treatment Outcome
anastomosis complications
bladder atony
deep infiltrating endometriosis
rectal nodule
robotic assistance
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
11 2023
11 2023
Historique:
revised:
27
08
2023
received:
13
06
2023
accepted:
29
08
2023
medline:
23
11
2023
pubmed:
18
10
2023
entrez:
18
10
2023
Statut:
ppublish
Résumé
The aim was to compare postoperative complications in patients undergoing the excision of a rectal endometriotic nodule over 3 cm by a robotic-assisted versus a conventional laparoscopic approach. We conducted a retrospective cohort study evaluating prospectively collected data. The main interventions included rectal shaving, disc excision or colorectal resection. All the surgeries were performed in one endometriosis reference institute. To evaluate factors significantly associated with the risk of anastomosis leakage or fistula and bladder atony, we conducted a multivariate logistic regression model. A total of 548 patients with rectal endometriotic nodule over 3 cm in diameter (#ENZIAN C3) were included in the final analysis. The demography and clinical characteristics of women managed by the robotic-assisted (n = 97) approach were similar to those of patients who underwent conventional laparoscopy (n = 451). The multivariate logistic regression demonstrated that the surgical approach (robotic-assisted vs. laparoscopic) was not associated with the rate of anastomosis leakage or fistula (adjusted odds ratio [aOR] 1.2, 95% confidence interval [CI] 0.3-4.0) and bladder dysfunction (aOR 0.5, 95% CI 0.1-1.8). A rectal nodule located lower than 6 cm from the anal verge was significantly associated with anastomosis leakage (aOR 4.1, 95% CI 1.4-10.8) and bladder atony (aOR 4.3, 95% CI 1.5-12.3). Anastomosis leakage was also associated with smoking (aOR 3.2, 95% CI 1.4-7.4), significant vaginal infiltration (aOR 2.7, 95% CI 1.2-6.7) and excision of nodules involving sacral roots (aOR 5.6, 95% CI 1.7-15.5). The robotic-assisted approach was not associated with increased risk of main postoperative complications compared to conventional laparoscopy for the treatment of large rectal endometriotic nodules.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2233-2242Informations de copyright
© 2023 Association of Coloproctology of Great Britain and Ireland.
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