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Background: At present, few articles compare the differences between robot-assisted thoracic surgeries (RATSs) and video-assisted thoracic surgeries (VATSs) in the day surgery model and there is also little literature on what factors influence delayed discharge from day surgery. This study aims to compare short-term outcomes between RATS and VATS for segmental lung resection in a day surgery setting, and to identify risk factors for delayed discharge.
Methods: A retrospective analysis was performed on 204 patients with early-stage non-small-cell lung cancer (NSCLC) who underwent segmental lung resection via RATS or VATS at the First People's Hospital of Changzhou City from January 2021 to December 2023. The clinical data and short-term efficacy of the two groups were compared, and the patients were divided into two subgroups based on whether the patients were discharged within 48 hours. One group was day surgery patients who were discharged within 48 hours, and the other group was day surgery patients with delayed discharge, so as to explore the factors affecting the delayed discharge of day surgery.
Results: Compared to the VATS group, the RATS group had a shorter average surgery duration (58.59±12.20 66.12±21.56 min, P<0.001), less intraoperative blood loss (98.77±51.50 128.87±65.79 mL, P=0.02), lower total postoperative drainage (185.44±109.14 268.70±147.99 mL, P=0.007), and a shorter postoperative drainage duration (1.74±0.30 2.29±0.98 days, P=0.045). The patients experienced less pain, with lower total drug dose of intramuscular diclofenac sodium lidocaine injection and oral celecoxib capsules (111.76±40.52 167.74±67.20 mg, P<0.001) and reduced pain scores (3.29±0.66 4.31±0.81, P=0.003). Fewer patients in the RATS group experienced delayed discharges (11 39, P<0.001), and the incidence of postoperative complications was lower (nausea and vomiting: 3.9% 3.9%, fever: 4.9% 13.5%, pulmonary atelectasis: 0% 2.0%, infection: 1.0% 2.9%, air leakage: 6.9% 8.8%, abnormal drainage fluid: 0% 8.8%, P=0.23; recovery: P=0.27). Meanwhile, subgroup analysis revealed that the four indicators of 24-hour postoperative analgesic medication, operation time, intraoperative bleeding, and tumor history were statistically significant (tumor history: P=0.04; intraoperative bleeding: P=0.005; use of analgesic medication in the 24-hour postoperative period: P=0.001; duration of surgery: P=0.008).
Conclusions: In the surgery setting, RATSs showed better outcomes compared to VATSs, including shorter surgical duration, reduced intraoperative blood loss, lower postoperative drainage volume, shorter drainage duration, and fewer postoperative complications. History of tumor, intraoperative bleeding, use of analgesic medication in the 24-hour postoperative period, and duration of surgery were risk factors for delayed discharge from day surgery.
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http://dx.doi.org/10.21037/jtd-24-1020 | DOI Listing |
J Am Acad Orthop Surg Glob Res Rev
December 2024
From the Connecticut Orthopaedics, Fairfield, CT (Dr. Bernstein); the Epidemiology and Real-World Data Sciences, Johnson & Johnson MedTech, New Brunswick, NJ (Dr. Gupta and Ruppenkamp); the Global Health Economics and Market Access, Johnson & Johnson MedTech, Raynham, MA (Dr. Kabiri and Goldstein); and the Medical Affairs, Johnson & Johnson MedTech, Palm Beach Gardens, FL (Dr. Diaz).
Background: Computer-assisted fluoroscopic navigation and robotic technologies aim to optimize implant placement and alignment in primary total hip arthroplasty (THA) to improve patient outcomes. This study uses a retrospective hospital billing database covering 1,300 hospitals to compare the clinical and economic effect of these technologies.
Methods: The study compared patients undergoing THA with robotic versus computer-assisted fluoroscopic navigation technologies between January 1, 2016, and September 30, 2021, using the Premier Healthcare Database.
J Bone Joint Surg Am
December 2024
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
Background: Weight optimization methods in morbidly obese patients with a body mass index (BMI) of ≥40 kg/m2 undergoing total knee arthroplasty (TKA) have shown mixed results. The purpose of this study was to evaluate the effect of perioperative use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients with a BMI of ≥40 kg/m2 undergoing primary TKA.
Methods: Using an administrative claims database, patients with morbid obesity undergoing primary TKA were stratified into GLP-1 RA use for 3 months before and after the surgical procedure (treatment group) and GLP-1 RA non-use (control group), and were matched on the basis of patient age, gender, diagnosis of type-2 diabetes mellitus, and Charlson Comorbidity Index (CCI).
J Am Acad Orthop Surg Glob Res Rev
December 2024
From the Department of Orthopaedic Surgery, UT Health San Antonio, San Antonio, TX.
Introduction: Depression is among the most common mental illnesses, with an estimated 8.1% of adults in the United States living with the condition. Despite its prevalence, the effect of depression on surgical outcomes is not well studied.
View Article and Find Full Text PDFJ Minim Access Surg
December 2024
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Introduction: Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al. Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre.
Patients And Methods: A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively.
Updates Surg
December 2024
Surgery Clinic 3, Regional Institute of Gastroenterology and Hepatology "Prof. Dr. Octavian Fodor", "Iuliu Hațieganul" University of Medicine and Pharmacy, 400394, Cluj-Napoca-Napoca, Romania.
Patients with esophageal cancer and concomitant liver cirrhosis (LC) pose a surgical challenge because of the increased risk of postoperative complications and mortality. Purpose of this study was to review the existing literature and estimate perioperative short-term outcomes of esophagectomy in this patient population. Systematic review and meta-analysis.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!