title: Risk factors for postoperative complications in robotic general surgery.
abstract: The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study. All consecutive robotic surgical procedures from November 2001 to December 2013 were included. One thousand consecutive general surgery patients met the inclusion criteria. The mean overall postoperative morbidity and major postoperative morbidity (Clavien >III) rates were 20.4 and 6 %, respectively. This included a conversion rate of 4.4 %, reoperation rate of 4.5 %, and mortality rate of 0.2 %. Multivariate analysis showed that ASA score >3 [OR 1.7; 95 % CI (1.2-2.4)], hematocrit value <38 [OR 1.6; 95 % CI (1.1-2.2)], previous abdominal surgery [OR 1.5; 95 % CI (1-2)], advanced dissection [OR 5.8; 95 % CI (3.1-10.6)], and multiquadrant surgery [OR 2.5; 95 % CI (1.7-3.8)] remained independent risk factors for overall postoperative morbidity. It also showed that advanced dissection [OR 4.4; 95 % CI (1.9-9.6)] and multiquadrant surgery [OR 4.4; 95 % CI (2.3-8.5)] remained independent risk factors for major postoperative morbidity (Clavien >III). This study identifies independent risk factors for postoperative overall and major morbidity in robotic general surgery. Because these factors independently impacted postoperative complications, we believe they could be taken into account in future studies comparing conventional versus robot-assisted laparoscopic procedures in general surgery.
authors.affiliation: Department of Digestive, Hepato-Biliary, Endocrine, and Surgical Oncology, CHU Nancy-Hospital Brabois Adultes, University de Lorraine, 11 allee du morvan, 54511, Vandoeuvre les Nancy, France.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fantola
authors.affiliation: Department of Digestive, Hepato-Biliary, Endocrine, and Surgical Oncology, CHU Nancy-Hospital Brabois Adultes, University de Lorraine, 11 allee du morvan, 54511, Vandoeuvre les Nancy, France. l.brunaud@chru-nancy.fr.|Faculty de medicine, INSERM U954, University de Lorraine, Nancy, France. l.brunaud@chru-nancy.fr.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.affiliation: Clinical Epidemiology and Evaluation Department, INSERM, CIC-EC1433, CHU Nancy, Pôle S2R, University de Lorraine, 54000, Nancy, France.
authors.forename: Phi-Linh
authors.initials: PL
authors.lastname: Nguyen-Thi
authors.affiliation: Department of Digestive, Hepato-Biliary, Endocrine, and Surgical Oncology, CHU Nancy-Hospital Brabois Adultes, University de Lorraine, 11 allee du morvan, 54511, Vandoeuvre les Nancy, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Germain
authors.affiliation: Department of Digestive, Hepato-Biliary, Endocrine, and Surgical Oncology, CHU Nancy-Hospital Brabois Adultes, University de Lorraine, 11 allee du morvan, 54511, Vandoeuvre les Nancy, France.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ayav
authors.affiliation: Department of Digestive, Hepato-Biliary, Endocrine, and Surgical Oncology, CHU Nancy-Hospital Brabois Adultes, University de Lorraine, 11 allee du morvan, 54511, Vandoeuvre les Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bresler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075204:Contraindications, Procedure; D005260:Female; D013502:General Surgery / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012372:ROC Curve; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures / Q000009:adverse effects*
keywords: Laparoscopy; Morbidity; Mortality; Postoperative complications; Risk factors; Robotics