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Enhanced recovery after surgery may mitigate the risks associated with robotic-assisted fundoplication in lung transplant patients.

Authors :
Wu, Rebecca
Robayo, Valeria
Nguyen, Duc T.
Chan, Edward Y.
Chihara, Ray
Huang, Howard J.
Graviss, Edward A.
Kim, Min P.
Source :
Surgical Endoscopy & Other Interventional Techniques; Apr2024, Vol. 38 Issue 4, p2134-2141, 8p
Publication Year :
2024

Abstract

Introduction: A history of lung transplantation is a risk factor for poor outcomes in patients undergoing laparoscopic fundoplication. We wanted to determine whether enhanced recovery after a robotic-assisted surgery program would mitigate these risks. Methods: We performed a single-center retrospective analysis of the Society of Thoracic Surgery database for patients who underwent elective antireflux procedures from 1/2018 to 2/2021 under the enhanced recovery after surgery program using robotic assistance. We identified the patient and surgical characteristics, morbidity, length of stay, and 30-day readmission rates. Results: Among 386 patients who underwent barrier creation, 41 had previously undergone a lung transplant, either bilateral (n = 28) or single (n = 13). There were no significant differences in postoperative complications (9.8% vs. 5.2%, p = 0.27), median hospital length of stay (1 d vs. 1 d, p = 0.28), or 30-day readmission (7.3% vs. 4.9%, p = 0.46). Bivariate analysis showed that older age (p = 0.03), history of DVT/PE (p < 0.001), history of cerebrovascular events (p = 0.03), opioid dependence (p = 0.02), neurocognitive dysfunction (p < 0.001), and dependent functional status (p = 0.02) were associated with postoperative complications. However, lung transplantation was not associated with an increased risk of postoperative complications (p = 0.28). Discussion: The risk of surgical complications in patients with a history of lung transplantation may be mitigated by the combination of ERAS and minimally invasive surgery such as robot-assisted surgery. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18666817
Volume :
38
Issue :
4
Database :
Complementary Index
Journal :
Surgical Endoscopy & Other Interventional Techniques
Publication Type :
Academic Journal
Accession number :
176339474
Full Text :
https://doi.org/10.1007/s00464-024-10719-9