OBJECTIVE To compare robotic-assisted proctectomy with ileal pouch-anal anastomosis (R-IPAA) outcomes and laparoscopic proctectomy with ileal pouch-anal anastomosis (L-IPAA) within a specialized robotic surgery center, using matching techniques to minimize potential confounding factors. SUMMARY BACKGROUND DATA Minimally invasive approaches, particularly laparoscopy, have improved outcomes for IBD and FAP patients undergoing IPAA. Robotic-assisted surgery offers potential technical advantages, but its definitive superiority over laparoscopy in this context remains under debate. METHODS This retrospective, STROBE-compliant study analyzed 234 consecutive IPAA patients (117 robotic, 117 laparoscopic). Data encompassed patient demographics, intraoperative details, and postoperative outcomes. We employed various matching techniques to address potential bias. Primary endpoints focused on 30-day complications, readmissions, and reoperations, with secondary endpoints including hospital stay, blood loss, and stoma closure rates. RESULTS R-IPAA demonstrated a lower conversion rate to open surgery (P=0.02), a shorter hospital stay (P=0.04), and reduced blood loss (P=0.0003) compared to L-IPAA. While overall 30-day morbidity rates were similar (P=0.4), matched analyses suggested a trend towards fewer reoperations and 3-month IPAA-associated complications after diverting loop ileostomy closure in the robotic group. However, these differences did not reach statistical significance. CONCLUSIONS In a high-volume robotic surgery center, R-IPAA reduced the risk of conversion to open surgery while reducing intraoperative blood loss and providing shorter length of stay with equivalent perioperative outcomes. Promising trends to reduce 30-day reoperations and surgical complications following DLI closure were observed after a matching analysis.

中文翻译：

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评估机器人 IPAA 的影响：来自大容量中心的案例匹配分析。


目的 比较专业机器人手术中心内机器人辅助直肠切除术联合回肠贮袋肛门吻合术 (R-IPAA) 和腹腔镜直肠切除术联合回肠贮袋肛门吻合术 (L-IPAA) 的结果，使用匹配技术最大限度地减少潜在的混杂因素。摘要背景数据微创方法，特别是腹腔镜检查，改善了接受 IPAA 的 IBD 和 FAP 患者的预后。机器人辅助手术具有潜在的技术优势，但在这种情况下其相对于腹腔镜手术的绝对优势仍存在争议。方法 这项符合 STROBE 标准的回顾性研究分析了 234 名连续 IPAA 患者（117 名机器人患者，117 名腹腔镜患者）。数据包括患者人口统计、术中细节和​​术后结果。我们采用了各种匹配技术来解决潜在的偏见。主要终点侧重于 30 天并发症、再入院和再次手术，次要终点包括住院时间、失血量和造口闭合率。结果 与 L-IPAA 相比，R-IPAA 的开放手术转化率较低（P=0.02），住院时间较短（P=0.04），失血量较少（P=0.0003）。虽然总体 30 天发病率相似 (P=0.4)，但匹配分析表明，机器人组在改道袢回肠造口闭合术后，出现再次手术和 3 个月 IPAA 相关并发症减少的趋势。然而，这些差异并未达到统计学显着性。结论 在大容量机器人手术中心，R-IPAA 降低了转为开放手术的风险，同时减少了术中失血量，缩短了住院时间，且围手术期结果相同。 匹配分析后观察到减少 DLI 闭合后 30 天再次手术和手术并发症的良好趋势。