Literature DB >> 28275918

Robotic thoracic surgery results in shorter hospital stay and lower postoperative pain compared to open thoracotomy: a matched pairs analysis.

Christopher Darr1, Danjouma Cheufou2, Gerhard Weinreich3, Thomas Hachenberg4, Clemens Aigner2, Sandra Kampe5,6.   

Abstract

BACKGROUND: To evaluate postoperative pain intensity and length of hospital stay after open or robotic thoracic surgery in a standardized postoperative pain therapy setting.
METHODS: In the present retrospective (oberservation period: January 2015 until January 2016) study we matched data of 38 patients with robotic thoracic surgery ("robotic patients"; age: 62.2 years, male gender: 42.1%) with 38 patients with open thoracic surgery ("open patients"; age: 62.5 years, male gender: 42.1%). Power analysis indicated that 36 patients per group would be required.
RESULTS: 68% of all patients received an epidural catheter, and 32% a systemic opioid based analgesia. Postoperative pain intensity in "robotic patients" was lower at rest on postoperative day 3-5 compared to "open patients" (NRS POD 3 robotic surgery 0.5±1.0 vs. open surgery 1.0±1.6, p = 0.04; NRS POD 4 robotic surgery 0,5 ± 1.0 vs. open surgery 1.1±1.3, p=0.04; NRS POD 5 robotic surgery 0.7 ± 1.0 vs. open surgery 1.5±1.5, p=0.003). Chest tube duration was shorter in "robotic patients" (2.9 ± 2.0 days vs. 4.9 ± 2.2 days; p < 0.001). Moreover, length of hospital stay was shorter in "robotic patients" than in "open patients" (6.9 days vs. 8.0 days; p = 0.02). There was no significant difference in postoperative opioid consumption between the groups. Nearly 95% of patients were discharged home with an oral opioid in both groups.
CONCLUSION: Patients after robotic pulmonary resection experience lower postoperative pain and are discharged earlier from hospital than patients after open thoracic surgery. STUDY LIMITATIONS: The study design is retrospectively.

Entities:  

Keywords:  Controlled-release oxycodone; Epidural analgesia; Hospital stay; Open thoracotomy; Pain scores; Postoperative analgesia; Robotic pulmonary resection

Mesh:

Substances:

Year:  2017        PMID: 28275918     DOI: 10.1007/s00464-017-5464-6

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  19 in total

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5.  Comparison of robotic and video-assisted thoracic surgery for lung cancer: a propensity-matched analysis.

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6.  Analgesia and pulmonary function after lung surgery: is a single intercostal nerve block plus patient-controlled intravenous morphine as effective as patient-controlled epidural anaesthesia? A randomized non-inferiority clinical trial.

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7.  Controlled-Release Oxycodone as "Gold Standard" for Postoperative Pain Therapy in Patients Undergoing Video-Assisted Thoracic Surgery or Thoracoscopy: A Retrospective Evaluation of 788 Cases.

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Review 9.  A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy--a systematic review and meta-analysis of randomized trials.

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Authors:  Sandra Kampe; Gerhard Weinreich; Christopher Darr; Kolja Eicker; Georgios Stamatis; Thomas Hachenberg
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Review 4.  Assessment and pathophysiology of pain in cardiac surgery.

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Review 5.  Anesthetic Implications of Robotic-Assisted Surgery in Pediatric Patients.

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6.  [Reflection on the Biological Significance of Minimally Invasive Surgery for Lung Cancer].

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Journal:  Zhongguo Fei Ai Za Zhi       Date:  2018-03-20

7.  Association of surgical approach and prolonged opioid prescriptions in patients undergoing major pelvic cancer procedures.

Authors:  Marieke J Krimphove; Xi Chen; Maya Marchese; David F Friedlander; Adam C Fields; Lina Roa; Daniel Pucheril; Adam S Kibel; Nelya Melnitchouk; Richard D Urman; Luis A Kluth; Prokar Dasgupta; Quoc-Dien Trinh
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