Evidence map›Paper›PMID 39404860›Full record

ArticleTechniques in coloproctology2024

Open vs. laparoscopic vs. robotic pouch excision: unveiling the best approach for optimal outcomes.

T Violante, D Ferrari, R Sassun, A Sileo, J C Ng, K L Mathis, R R Cima, E J Dozois, D W Larson

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
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

9 authors.

T Violante *Department of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
D Ferrari *Department of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
R SassunDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
A SileoDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
J C NgDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
K L MathisDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
R R CimaDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
E J DozoisDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA.
D W LarsonDepartment of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, USA. Larson.David2@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite advantages for patients with ulcerative colitis, Crohn's disease, and familial adenomatous polyposis, restorative proctocolectomy with ileal pouch-anal anastomosis carries a risk of pouch failure, necessitating pouch excision. The traditional open approach is associated with potential complications. Robotic and laparoscopic techniques are emerging, but comparative outcome data are limited.

methodsWe conducted a retrospective study of consecutive adult patients undergoing robotic, laparoscopic, and open ileal pouch excision at Mayo Clinic, Rochester, MN, between January 2015 and December 2023. We analyzed data on patient characteristics, perioperative variables, and postoperative outcomes, focusing on short-term complications. Statistical analysis included appropriate tests.

resultsThe study included 123 patients: 23 underwent robotic-assisted pouch excision, 12 laparoscopic, and 82 open. The robotic approach had the longest median operative time (334 ± 170 min, p = 0.03). However, it demonstrated significantly lower estimated blood loss than open (150 ± 200 ml vs. 350 ± 300 ml, p = 0.002) and laparoscopic surgery (250 ± 250 ml, p = 0.005). Robotic and laparoscopic groups required fewer preoperative ureteral stents than the open group (p = 0.001). Additionally, the robotic approach utilized fewer pelvic drainages (p < 0.0001) and had a lower rate of lysis of adhesions > 60 min compared to open surgery (p = 0.003). Robotic procedures had significantly lower 30-day postoperative complications than the open approach (30.4% vs. 65.9%, p = 0.002) while also demonstrating fewer 30-day reoperations than the laparoscopic group (p = 0.04).

conclusionsRobotic-assisted pouch excision offered significant benefits, including decreased EBL, reduced need for preoperative ureteral stents, and significantly fewer 30-day postoperative complications compared to open surgery.

Indexed as

Colonic PouchesLaparoscopyOperative TimePostoperative ComplicationsProctocolectomy, RestorativeRobotic Surgical ProceduresAdultBlood Loss, SurgicalColitis, UlcerativeFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeIPAALaparoscopicPouch excisionRobotic

Identifiers

PMID39404860

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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.