Skip to main content
Erschienen in: Journal of Robotic Surgery 1/2024

01.12.2024 | Research

Comparative analysis of robotic and laparoscopic surgery for mid and low rectal cancer in patients with varied body mass indexes: evaluating of short-term outcomes

verfasst von: Shuai Zhao, Ruiqi Li, Jiajie Zhou, Longhe Sun, Qiannan Sun, Wei Wang, Daorong Wang

Erschienen in: Journal of Robotic Surgery | Ausgabe 1/2024

Einloggen, um Zugang zu erhalten

Abstract

The main aim of this study was to evaluate and contrast the efficacy of robotic and laparoscopic surgical procedures in the treatment of low and mid rectal cancer in different BMI (body mass index) groups. The clinical records of patients who had laparoscopic or robotic proctectomy at a single center between December 2019 and August 2023 were analyzed. Then we utilized a classification framework to categorize individuals based on their BMI into three unique groups: non-obese, overweight, and obese. The short-term efficacy was evaluated. A consecutive sample of 1413 patients was included in this retrospective investigation. 1158 people out of the total sample chose laparoscopic surgery, whereas 255 people chose robotic surgery. In the group of obese people, robotic surgery showed a statistically significant decrease in blood loss compared to laparoscopic surgery (P = 0.026). People who were overweight or obese were in the hospital for a shorter amount of time after robotic surgery than after laparoscopic surgery (P = 0.033 and P = 0.031, respectively). People with different BMIs in the robotic surgery group took less time to have a flatus passage and oral intake those in the laparoscopic surgery group. Oncological outcomes and the frequency of complications were comparable between the two treatments with different BMIs. Surgical resection of patients undergoing low-anterior surgery may benefit from a robotic approach, particularly in overweight and obese patients.
Literatur
1.
Zurück zum Zitat Li R, Zhou J, Zhao S, Sun Q, Wang D (2023) Propensity matched analysis of robotic and laparoscopic operations for mid-low rectal cancer: short-term comparison of anal function and oncological outcomes. J Robot Surg. 17(5):2339–2350CrossRefPubMed Li R, Zhou J, Zhao S, Sun Q, Wang D (2023) Propensity matched analysis of robotic and laparoscopic operations for mid-low rectal cancer: short-term comparison of anal function and oncological outcomes. J Robot Surg. 17(5):2339–2350CrossRefPubMed
2.
Zurück zum Zitat Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150PubMed Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150PubMed
3.
Zurück zum Zitat Hoshino N, Sakamoto T, Hida K, Sakai Y (2019) Robotic versus laparoscopic surgery for rectal cancer: an overview of systematic reviews with quality assessment of current evidence. Surg Today 49(7):556–570CrossRefPubMed Hoshino N, Sakamoto T, Hida K, Sakai Y (2019) Robotic versus laparoscopic surgery for rectal cancer: an overview of systematic reviews with quality assessment of current evidence. Surg Today 49(7):556–570CrossRefPubMed
4.
Zurück zum Zitat Stevenson AR, Solomon MJ, Lumley JW, Hewett P, Clouston AD, Gebski VJ et al (2015) Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial. JAMA 314(13):1356–1363CrossRefPubMed Stevenson AR, Solomon MJ, Lumley JW, Hewett P, Clouston AD, Gebski VJ et al (2015) Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial. JAMA 314(13):1356–1363CrossRefPubMed
5.
Zurück zum Zitat Bianchi PP, Ceriani C, Locatelli A, Spinoglio G, Zampino MG, Sonzogni A et al (2010) Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomes. Surg Endosc 24(11):2888–2894CrossRefPubMed Bianchi PP, Ceriani C, Locatelli A, Spinoglio G, Zampino MG, Sonzogni A et al (2010) Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomes. Surg Endosc 24(11):2888–2894CrossRefPubMed
6.
Zurück zum Zitat Weber PA, Merola S, Wasielewski A, Ballantyne GH. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum. 2002;45(12):1689–1694; discussion 95–6 Weber PA, Merola S, Wasielewski A, Ballantyne GH. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum. 2002;45(12):1689–1694; discussion 95–6
7.
Zurück zum Zitat Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB (2006) Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc 20(10):1521–1525CrossRefPubMed Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB (2006) Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc 20(10):1521–1525CrossRefPubMed
8.
Zurück zum Zitat Ahmad A, Ahmad ZF, Carleton JD, Agarwala A (2017) Robotic surgery: current perceptions and the clinical evidence. Surg Endosc 31(1):255–263CrossRefPubMed Ahmad A, Ahmad ZF, Carleton JD, Agarwala A (2017) Robotic surgery: current perceptions and the clinical evidence. Surg Endosc 31(1):255–263CrossRefPubMed
9.
Zurück zum Zitat Tang B, Lei X, Ai J, Huang Z, Shi J, Li T (2021) Comparison of robotic and laparoscopic rectal cancer surgery: a meta-analysis of randomized controlled trials. World J Surg Oncol 19(1):38CrossRefPubMedPubMedCentral Tang B, Lei X, Ai J, Huang Z, Shi J, Li T (2021) Comparison of robotic and laparoscopic rectal cancer surgery: a meta-analysis of randomized controlled trials. World J Surg Oncol 19(1):38CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Sueda T, Tei M, Nishida K, Yoshikawa Y, Matsumura T, Koga C et al (2022) Short-term outcomes of robotic-assisted versus conventional laparoscopic-assisted surgery for rectal cancer: a propensity score-matched analysis. J Robot Surg 16(2):323–331CrossRefPubMed Sueda T, Tei M, Nishida K, Yoshikawa Y, Matsumura T, Koga C et al (2022) Short-term outcomes of robotic-assisted versus conventional laparoscopic-assisted surgery for rectal cancer: a propensity score-matched analysis. J Robot Surg 16(2):323–331CrossRefPubMed
11.
Zurück zum Zitat Feng Q, Yuan W, Li T, Tang B, Jia B, Zhou Y et al (2022) Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol 7(11):991–1004CrossRefPubMed Feng Q, Yuan W, Li T, Tang B, Jia B, Zhou Y et al (2022) Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol 7(11):991–1004CrossRefPubMed
12.
Zurück zum Zitat Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J et al (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA 318(16):1569–1580CrossRefPubMedPubMedCentral Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J et al (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA 318(16):1569–1580CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Wang H, Zhai F (2013) Programme and policy options for preventing obesity in China. Obes Rev 14 Suppl 2(0 2):134–140 Wang H, Zhai F (2013) Programme and policy options for preventing obesity in China. Obes Rev 14 Suppl 2(0 2):134–140
14.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES et al (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372(14):1324–1332CrossRefPubMed Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES et al (2015) A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med 372(14):1324–1332CrossRefPubMed
16.
Zurück zum Zitat Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG et al (2013) Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100(1):75–82CrossRefPubMed Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG et al (2013) Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100(1):75–82CrossRefPubMed
17.
Zurück zum Zitat Braga M, Frasson M, Vignali A, Zuliani W, Capretti G, Di Carlo V (2007) Laparoscopic resection in rectal cancer patients: outcome and cost-benefit analysis. Dis Colon Rectum 50(4):464–471CrossRefPubMed Braga M, Frasson M, Vignali A, Zuliani W, Capretti G, Di Carlo V (2007) Laparoscopic resection in rectal cancer patients: outcome and cost-benefit analysis. Dis Colon Rectum 50(4):464–471CrossRefPubMed
18.
Zurück zum Zitat Liang X, Hou S, Liu H, Li Y, Jiang B, Bai W et al (2011) Effectiveness and safety of laparoscopic resection versus open surgery in patients with rectal cancer: a randomized, controlled trial from China. J Laparoendosc Adv Surg Tech A 21(5):381–385CrossRefPubMed Liang X, Hou S, Liu H, Li Y, Jiang B, Bai W et al (2011) Effectiveness and safety of laparoscopic resection versus open surgery in patients with rectal cancer: a randomized, controlled trial from China. J Laparoendosc Adv Surg Tech A 21(5):381–385CrossRefPubMed
19.
Zurück zum Zitat Matsuzaki H, Ishihara S, Kawai K, Murono K, Otani K, Yasuda K et al (2017) Laparoscopic versus open surgery for obese patients with rectal cancer: a retrospective cohort study. Surg Today 47(5):627–635CrossRefPubMed Matsuzaki H, Ishihara S, Kawai K, Murono K, Otani K, Yasuda K et al (2017) Laparoscopic versus open surgery for obese patients with rectal cancer: a retrospective cohort study. Surg Today 47(5):627–635CrossRefPubMed
20.
Zurück zum Zitat Ishihara S, Watanabe T, Fukushima Y, Akahane T, Horiuchi A, Shimada R et al (2014) Safety and factors contributing to the difficulty of laparoscopic surgery for rectal cancer treated with preoperative chemoradiotherapy. Tech Coloproctol 18(3):247–255CrossRefPubMed Ishihara S, Watanabe T, Fukushima Y, Akahane T, Horiuchi A, Shimada R et al (2014) Safety and factors contributing to the difficulty of laparoscopic surgery for rectal cancer treated with preoperative chemoradiotherapy. Tech Coloproctol 18(3):247–255CrossRefPubMed
21.
Zurück zum Zitat Feng Q, Tang W, Zhang Z, Wei Y, Ren L, Chang W et al (2022) Robotic versus laparoscopic abdominoperineal resections for low rectal cancer: a single-center randomized controlled trial. J Surg Oncol 126(8):1481–1493CrossRefPubMed Feng Q, Tang W, Zhang Z, Wei Y, Ren L, Chang W et al (2022) Robotic versus laparoscopic abdominoperineal resections for low rectal cancer: a single-center randomized controlled trial. J Surg Oncol 126(8):1481–1493CrossRefPubMed
22.
Zurück zum Zitat Martínez-Pérez A, Carra MC, Brunetti F, de’Angelis N (2017) Pathologic outcomes of laparoscopic vs open mesorectal excision for rectal cancer: a systematic review and meta-analysis. JAMA Surg. 152(4):e165665CrossRefPubMed Martínez-Pérez A, Carra MC, Brunetti F, de’Angelis N (2017) Pathologic outcomes of laparoscopic vs open mesorectal excision for rectal cancer: a systematic review and meta-analysis. JAMA Surg. 152(4):e165665CrossRefPubMed
23.
Zurück zum Zitat Chen TC, Liang JT (2019) Robotic transabdominal intersphinteric resection with lateral pelvic lymph node dissection for patients with distal rectal cancer—a video vignette. Colorectal Dis 21(11):1337–1338CrossRefPubMed Chen TC, Liang JT (2019) Robotic transabdominal intersphinteric resection with lateral pelvic lymph node dissection for patients with distal rectal cancer—a video vignette. Colorectal Dis 21(11):1337–1338CrossRefPubMed
24.
Zurück zum Zitat Gorgun E, Ozben V, Costedio M, Stocchi L, Kalady M, Remzi F (2016) Robotic versus conventional laparoscopic rectal cancer surgery in obese patients. Colorectal Dis 18(11):1063–1071CrossRefPubMed Gorgun E, Ozben V, Costedio M, Stocchi L, Kalady M, Remzi F (2016) Robotic versus conventional laparoscopic rectal cancer surgery in obese patients. Colorectal Dis 18(11):1063–1071CrossRefPubMed
25.
Zurück zum Zitat Panteleimonitis S, Pickering O, Abbas H, Harper M, Kandala N, Figueiredo N et al (2018) Robotic rectal cancer surgery in obese patients may lead to better short-term outcomes when compared to laparoscopy: a comparative propensity scored match study. Int J Colorectal Dis 33(8):1079–1086CrossRefPubMedPubMedCentral Panteleimonitis S, Pickering O, Abbas H, Harper M, Kandala N, Figueiredo N et al (2018) Robotic rectal cancer surgery in obese patients may lead to better short-term outcomes when compared to laparoscopy: a comparative propensity scored match study. Int J Colorectal Dis 33(8):1079–1086CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Myrseth E, Nymo LS, Gjessing PF, Kørner H, Kvaløy JT, Norderval S (2022) Lower conversion rate with robotic assisted rectal resections compared with conventional laparoscopy; a national cohort study. Surg Endosc 36(5):3574–3584CrossRefPubMed Myrseth E, Nymo LS, Gjessing PF, Kørner H, Kvaløy JT, Norderval S (2022) Lower conversion rate with robotic assisted rectal resections compared with conventional laparoscopy; a national cohort study. Surg Endosc 36(5):3574–3584CrossRefPubMed
27.
Zurück zum Zitat Pai A, Alsabhan F, Park JJ, Melich G, Sulo S, Marecik SJ (2017) The impact of obesity on the perioperative, clinicopathologic, and oncologic outcomes of robot assisted total mesorectal excision for rectal cancer. Pol Przegl Chir 89(4):23–28CrossRefPubMed Pai A, Alsabhan F, Park JJ, Melich G, Sulo S, Marecik SJ (2017) The impact of obesity on the perioperative, clinicopathologic, and oncologic outcomes of robot assisted total mesorectal excision for rectal cancer. Pol Przegl Chir 89(4):23–28CrossRefPubMed
28.
Zurück zum Zitat Jeyarajah S, Sutton CD, Miller AS, Hemingway D (2007) Factors that influence the adequacy of total mesorectal excision for rectal cancer. Colorectal Dis 9(9):808–815CrossRefPubMed Jeyarajah S, Sutton CD, Miller AS, Hemingway D (2007) Factors that influence the adequacy of total mesorectal excision for rectal cancer. Colorectal Dis 9(9):808–815CrossRefPubMed
29.
Zurück zum Zitat Wang X, Cao G, Mao W, Lao W, He C (2020) Robot-assisted versus laparoscopic surgery for rectal cancer: a systematic review and meta-analysis. J Cancer Res Ther 16(5):979–989CrossRefPubMed Wang X, Cao G, Mao W, Lao W, He C (2020) Robot-assisted versus laparoscopic surgery for rectal cancer: a systematic review and meta-analysis. J Cancer Res Ther 16(5):979–989CrossRefPubMed
30.
Zurück zum Zitat Sun Y, Xu H, Li Z, Han J, Song W, Wang J et al (2016) Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis. World J Surg Oncol 14:61CrossRefPubMedPubMedCentral Sun Y, Xu H, Li Z, Han J, Song W, Wang J et al (2016) Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis. World J Surg Oncol 14:61CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat D’Annibale A, Pernazza G, Monsellato I, Pende V, Lucandri G, Mazzocchi P et al (2013) Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc 27(6):1887–1895CrossRefPubMed D’Annibale A, Pernazza G, Monsellato I, Pende V, Lucandri G, Mazzocchi P et al (2013) Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc 27(6):1887–1895CrossRefPubMed
32.
Zurück zum Zitat Aselmann H, Kersebaum JN, Bernsmeier A, Beckmann JH, Möller T, Egberts JH et al (2018) Robotic-assisted total mesorectal excision (TME) for rectal cancer results in a significantly higher quality of TME specimen compared to the laparoscopic approach-report of a single-center experience. Int J Colorectal Dis 33(11):1575–1581CrossRefPubMed Aselmann H, Kersebaum JN, Bernsmeier A, Beckmann JH, Möller T, Egberts JH et al (2018) Robotic-assisted total mesorectal excision (TME) for rectal cancer results in a significantly higher quality of TME specimen compared to the laparoscopic approach-report of a single-center experience. Int J Colorectal Dis 33(11):1575–1581CrossRefPubMed
33.
Zurück zum Zitat Park JS, Lee SM, Choi GS, Park SY, Kim HJ, Song SH et al (2023) Comparison of laparoscopic versus robot-assisted surgery for rectal cancers: the COLRAR randomized controlled trial. Ann Surg 278(1):31–38CrossRefPubMed Park JS, Lee SM, Choi GS, Park SY, Kim HJ, Song SH et al (2023) Comparison of laparoscopic versus robot-assisted surgery for rectal cancers: the COLRAR randomized controlled trial. Ann Surg 278(1):31–38CrossRefPubMed
34.
Zurück zum Zitat Kim MJ, Park SC, Park JW, Chang HJ, Kim DY, Nam BH et al (2018) Robot-assisted versus laparoscopic surgery for rectal cancer: a phase II open label prospective randomized controlled trial. Ann Surg 267(2):243–251CrossRefPubMed Kim MJ, Park SC, Park JW, Chang HJ, Kim DY, Nam BH et al (2018) Robot-assisted versus laparoscopic surgery for rectal cancer: a phase II open label prospective randomized controlled trial. Ann Surg 267(2):243–251CrossRefPubMed
35.
Zurück zum Zitat Safiejko K, Tarkowski R, Koselak M, Juchimiuk M, Tarasik A, Pruc M et al (2021) Robotic-assisted vs. standard laparoscopic surgery for rectal cancer resection: a systematic review and meta-analysis of 19,731 patients. Cancers (Basel) 14(1):180CrossRefPubMed Safiejko K, Tarkowski R, Koselak M, Juchimiuk M, Tarasik A, Pruc M et al (2021) Robotic-assisted vs. standard laparoscopic surgery for rectal cancer resection: a systematic review and meta-analysis of 19,731 patients. Cancers (Basel) 14(1):180CrossRefPubMed
36.
Zurück zum Zitat Mégevand JL, Lillo E, Amboldi M, Lenisa L, Ambrosi A, Rusconi A (2019) TME for rectal cancer: consecutive 70 patients treated with laparoscopic and robotic technique-cumulative experience in a single centre. Updates Surg 71(2):331–338CrossRefPubMed Mégevand JL, Lillo E, Amboldi M, Lenisa L, Ambrosi A, Rusconi A (2019) TME for rectal cancer: consecutive 70 patients treated with laparoscopic and robotic technique-cumulative experience in a single centre. Updates Surg 71(2):331–338CrossRefPubMed
37.
Zurück zum Zitat Zhao S, Zheng K, Zheng JC, Hou TT, Wang ZN, Xu HM et al (2019) Comparison of totally laparoscopic total gastrectomy and laparoscopic-assisted total gastrectomy: a systematic review and meta-analysis. Int J Surg 68:1–10CrossRefPubMedADS Zhao S, Zheng K, Zheng JC, Hou TT, Wang ZN, Xu HM et al (2019) Comparison of totally laparoscopic total gastrectomy and laparoscopic-assisted total gastrectomy: a systematic review and meta-analysis. Int J Surg 68:1–10CrossRefPubMedADS
38.
Zurück zum Zitat Corbellini C, Biffi R, Luca F, Chiappa A, Costa S, Bertani E et al (2016) Open, laparoscopic, and robotic surgery for rectal cancer: medium-term comparative outcomes from a multicenter study. Tumori 102(4):414–421CrossRefPubMed Corbellini C, Biffi R, Luca F, Chiappa A, Costa S, Bertani E et al (2016) Open, laparoscopic, and robotic surgery for rectal cancer: medium-term comparative outcomes from a multicenter study. Tumori 102(4):414–421CrossRefPubMed
Metadaten
Titel
Comparative analysis of robotic and laparoscopic surgery for mid and low rectal cancer in patients with varied body mass indexes: evaluating of short-term outcomes
verfasst von
Shuai Zhao
Ruiqi Li
Jiajie Zhou
Longhe Sun
Qiannan Sun
Wei Wang
Daorong Wang
Publikationsdatum
01.12.2024
Verlag
Springer London
Erschienen in
Journal of Robotic Surgery / Ausgabe 1/2024
Print ISSN: 1863-2483
Elektronische ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-023-01803-8

Weitere Artikel der Ausgabe 1/2024

Journal of Robotic Surgery 1/2024 Zur Ausgabe

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.