Evidence map›Paper›PMID 31820161›Full record

ArticleSurgical endoscopy2020

Trends and outcomes of robotic surgery for gastrointestinal (GI) cancers in the USA: maintaining perioperative and oncologic safety.

Ioannis T Konstantinidis, Philip Ituarte, Yanghee Woo, Susanne G Warner, Kurt Melstrom, Jae Kim, Gagandeep Singh, Byrne Lee, Yuman Fong, Laleh G Melstrom

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

26 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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

10 authors.

Ioannis T KonstantinidisDepartment of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA.ORCID 0000-0002-2849-356X
Philip ItuarteDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Yanghee WooDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Susanne G WarnerDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Kurt MelstromDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Jae KimDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Gagandeep SinghDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Byrne LeeDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Yuman FongDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA.
Laleh G MelstromDepartment of Surgery, City of Hope National Medical Center, Medical Office Bldg., 1500 East Duarte Road, Duarte, CA, 91010, USA. lmelstrom@coh.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveMinimally invasive surgery (MIS) continues to gain traction as a feasible approach for the operative management of gastrointestinal (GI) malignancies. The aim of this study is to quantify national trends, perioperative and oncologic outcomes of MIS for the most common GI malignancies including the esophagus, stomach, pancreas, colon, and rectum. We hypothesize that with more widespread use of MIS techniques, perioperative outcomes and oncologic resection quality will remain preserved.

methodsThe National Cancer Database (2010-2014) was utilized to assess perioperative outcomes and pathologic quality of MIS (robotic and laparoscopic) compared to open, in patients who underwent resection for cancers of the esophagus, stomach, pancreas, colon, and rectum. Multilevel logistic regression models were constructed to identify independent factors associated with postoperative and long-term outcomes.

resultsData from 11,023 esophageal, 30,664 gastric, 30,689 pancreas, 260,669 colon, and 52,239 rectal resections were analyzed. Although laparoscopy is the most prevalent MIS approach, the number of robotic resections increased nearly fourfold from 2010 to 2014 in all organ sites (increase by factor: esophagus: 3.8, stomach: 4.4, pancreas: 4.4, colon: 3.8 and rectum: 4). The number of laparoscopic resections increased at a slower rate (factor: 1.3-1.9), whereas the number of open resections decreased (factor: 0.67-0.77). Patients who underwent robotic-assisted resections were younger for stomach and colorectal resections and with lower Charlson Comorbidity Index across all sites. Patients who underwent robotic or laparoscopic resections had shorter hospitalizations, fewer readmissions (with the exception of rectal resections) and lower postoperative mortality at 90 days. Robotic-assisted resections had comparable negative margin resections and number of lymph nodes to laparoscopic and open resections across all sites.

conclusionThe utilization of robotic-assisted resections of GI cancers is rapidly increasing with more frequent use in younger and healthier patients. This study demonstrates that with the rising utilization of robotic-assisted resections, perioperative outcomes and oncologic safety have not been compromised.

Indexed as

AdenocarcinomaAdultAgedDatabases, FactualDigestive System NeoplasmsFemaleHumansLaparoscopyLogistic ModelsMaleMiddle AgedPatient SafetyPractice Patterns, Physicians'Retrospective StudiesRobotic Surgical ProceduresSurvival AnalysisGastrointestinal cancersOncologic outcomesPostoperative outcomesRobotic surgerySurvival

Identifiers

PMID31820161

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.