Evidence map›Paper›PMID 31312442›Full record

ArticleAnnals of medicine and surgery (2012)2019

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study.

Carly R Richards, Scott R Steele, Michael B Lustik, Suzanne M Gillern, Robert B Lim, Justin T Brady, Ali R Althans, Andrew T Schlussel

Open access · diamondAbstract read
In one paragraph

Article in Annals of medicine and surgery (2012), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Guideline
  2. [Robotic-assisted surgery of rectal cancer-Technique, limitations and results].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Carly R RichardsDepartment of Surgery, Tripler Army Medical Center, Honolulu, HI, United States.
Scott R SteeleDepartment of Colon & Rectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, United States.
Michael B LustikDepartment of Clinical Investigations, Tripler Army Medical Center, Honolulu, HI, United States.
Suzanne M GillernDepartment of Surgery, Tripler Army Medical Center, Honolulu, HI, United States.
Robert B LimDepartment of Surgery, Tripler Army Medical Center, Honolulu, HI, United States.
Justin T BradyDepartment of Surgery, University Hospitals Case Medical Center, Cleveland, OH, United States.
Ali R AlthansDepartment of Surgery, University Hospitals Case Medical Center, Cleveland, OH, United States.
Andrew T SchlusselDepartment of Surgery, Madigan Army Medical Center, Tacoma, WA, United States.
Tripler Army Medical Center · USUniversity Hospitals Cleveland Medical Center · USCleveland Clinic · USMadigan Army Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs our nation's population ages, operating on older and sicker patients occurs more frequently. Robotic operations have been thought to bridge the gap between a laparoscopic and an open approach, especially in more complex cases like proctectomy.

methodsOur objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly. A retrospective cross-sectional cohort study utilizing the Nationwide Inpatient Sample (NIS; 2006-2013) was performed. All cases were restricted to age 70 years old or greater.

resultsWe identified 6740 admissions for rectal cancer including: 5879 open, 666 laparoscopic, and 195 robotic procedures. The median age was 77 years old. The incidence of a robotic proctectomy increased by 39%, while the open approach declined by 6% over the time period studied. Median (interquartile range) length of stay was shorter for robotic procedures at 4.3 (3-7) days, compared to laparoscopic 5.8 (4-8) and open at 6.7 (5-10) days (p < 0.01), while median total hospital charges were greater in the robotic group compared to laparoscopic and open cases ($64,743 vs. $55,813 vs. $50,355, respectively, p < 0.01). There was no significant difference in the risk of total complications between the different approaches following multivariate analysis.

conclusionRobotic proctectomy was associated with a shorter LOS, and this may act as a surrogate marker for an overall improvement in adverse events. These results demonstrate that a robotic approach is a safe and feasible option, and should not be discounted solely based on age or comorbidities.

Indexed as

ElderlyNational in-patient sample(NIS)ProctectomyRobotic

Identifiers

PMID31312442
PMCPMC6610645
OpenAlexW2949614980

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.