Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database
Abstract Background The use of robot‐assisted surgery for rectal cancer is increasing, but its short‐term results remain unclear. We compared the short‐term outcomes of robot‐assisted and laparoscopic surgery for rectal cancer using a nationwide inpatient database. Methods We analyzed patients regis...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Annals of Gastroenterological Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ags3.12707 |
| _version_ | 1797639342748860416 |
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| author | Masako Mizoguchi Masashi Kizuki Noriko Iwata Masanori Tokunaga Kiyohide Fushimi Yusuke Kinugasa Takeo Fujiwara |
| author_facet | Masako Mizoguchi Masashi Kizuki Noriko Iwata Masanori Tokunaga Kiyohide Fushimi Yusuke Kinugasa Takeo Fujiwara |
| author_sort | Masako Mizoguchi |
| collection | DOAJ |
| description | Abstract Background The use of robot‐assisted surgery for rectal cancer is increasing, but its short‐term results remain unclear. We compared the short‐term outcomes of robot‐assisted and laparoscopic surgery for rectal cancer using a nationwide inpatient database. Methods We analyzed patients registered in the Japanese Diagnosis Procedure Combination database who underwent robot‐assisted or laparoscopic surgery for rectal cancer from April 2018 to March 2020. Postoperative complication rates, anesthesia time, length of hospital stay, and cost were compared using propensity score matching for low anterior resection (LAR), high anterior resection (HAR), and abdominoperineal resection (APR). Results Among 38 090 rectal cancer cases, 1992 LAR, 357 HAR, and 310 APR pairs were generated by propensity score matching and analyzed. Anesthesia time was longer for robot‐assisted surgery compared with laparoscopic surgery (LAR: 388.6 vs. 452.8 min, p < 0.001; HAR: 300.9 vs. 393.5 min, p < 0.001; APR: 4478.5 vs. 533.5 min, p < 0.001). Robot‐assisted surgery was associated with significantly shorter hospital stay for LAR (22.3 vs. 20.0 days, p < 0.001) and APR (29.2 vs. 25.9 days, p = 0.029). Total costs for LAR were significantly lower for robot‐assisted surgery (2031511.6 vs. 1955216.6 JPY, p < 0.001). The complication rates for robot‐assisted surgery tended to be fewer than laparoscopic surgery for all procedures, but the differences were not significant. Conclusions Although the anesthesia time was longer for robot‐assisted surgery, the procedure resulted in shorter hospital stay for LAR and APR, and lower costs for LAR compared with laparoscopic surgery. Robot‐assisted surgery can thus help to reduce costs and can be performed safely. |
| first_indexed | 2024-03-11T13:15:29Z |
| format | Article |
| id | doaj.art-4155ead75c61478dae3476700ca52bf1 |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-03-11T13:15:29Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-4155ead75c61478dae3476700ca52bf12023-11-03T13:04:50ZengWileyAnnals of Gastroenterological Surgery2475-03282023-11-017695596710.1002/ags3.12707Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination databaseMasako Mizoguchi0Masashi Kizuki1Noriko Iwata2Masanori Tokunaga3Kiyohide Fushimi4Yusuke Kinugasa5Takeo Fujiwara6Department of Gastrointestinal Surgery Tokyo Medical and Dental University Bunkyo‐ku JapanDepartment of Tokyo Metropolitan Health Policy Advisement Tokyo Medical and Dental University Bunkyo‐ku JapanDepartment of Gastrointestinal Surgery Tokyo Medical and Dental University Bunkyo‐ku JapanDepartment of Gastrointestinal Surgery Tokyo Medical and Dental University Bunkyo‐ku JapanDepartment of Health Policy and Informatics Tokyo Medical and Dental University Bunkyo‐ku JapanDepartment of Gastrointestinal Surgery Tokyo Medical and Dental University Bunkyo‐ku JapanDepartment of Global Health Promotion Tokyo Medical and Dental University Bunkyo‐ku JapanAbstract Background The use of robot‐assisted surgery for rectal cancer is increasing, but its short‐term results remain unclear. We compared the short‐term outcomes of robot‐assisted and laparoscopic surgery for rectal cancer using a nationwide inpatient database. Methods We analyzed patients registered in the Japanese Diagnosis Procedure Combination database who underwent robot‐assisted or laparoscopic surgery for rectal cancer from April 2018 to March 2020. Postoperative complication rates, anesthesia time, length of hospital stay, and cost were compared using propensity score matching for low anterior resection (LAR), high anterior resection (HAR), and abdominoperineal resection (APR). Results Among 38 090 rectal cancer cases, 1992 LAR, 357 HAR, and 310 APR pairs were generated by propensity score matching and analyzed. Anesthesia time was longer for robot‐assisted surgery compared with laparoscopic surgery (LAR: 388.6 vs. 452.8 min, p < 0.001; HAR: 300.9 vs. 393.5 min, p < 0.001; APR: 4478.5 vs. 533.5 min, p < 0.001). Robot‐assisted surgery was associated with significantly shorter hospital stay for LAR (22.3 vs. 20.0 days, p < 0.001) and APR (29.2 vs. 25.9 days, p = 0.029). Total costs for LAR were significantly lower for robot‐assisted surgery (2031511.6 vs. 1955216.6 JPY, p < 0.001). The complication rates for robot‐assisted surgery tended to be fewer than laparoscopic surgery for all procedures, but the differences were not significant. Conclusions Although the anesthesia time was longer for robot‐assisted surgery, the procedure resulted in shorter hospital stay for LAR and APR, and lower costs for LAR compared with laparoscopic surgery. Robot‐assisted surgery can thus help to reduce costs and can be performed safely.https://doi.org/10.1002/ags3.12707databaselaparoscopic surgeryrectal cancerretrospective studiesrobot‐assisted surgery |
| spellingShingle | Masako Mizoguchi Masashi Kizuki Noriko Iwata Masanori Tokunaga Kiyohide Fushimi Yusuke Kinugasa Takeo Fujiwara Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database Annals of Gastroenterological Surgery database laparoscopic surgery rectal cancer retrospective studies robot‐assisted surgery |
| title | Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database |
| title_full | Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database |
| title_fullStr | Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database |
| title_full_unstemmed | Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database |
| title_short | Comparison of short‐term outcomes between robot‐assisted and laparoscopic rectal surgery for rectal cancer: A propensity score‐matched analysis using the Japanese Nationwide diagnosis procedure combination database |
| title_sort | comparison of short term outcomes between robot assisted and laparoscopic rectal surgery for rectal cancer a propensity score matched analysis using the japanese nationwide diagnosis procedure combination database |
| topic | database laparoscopic surgery rectal cancer retrospective studies robot‐assisted surgery |
| url | https://doi.org/10.1002/ags3.12707 |
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