Perioperative medicine & outcomes
Postoperative Pulmonary Complications in Conventional Laparoscopic vs Robot-Assisted Abdominal Surgery
Authors' conclusion
In this cohort study, patients who received RAS vs CLS had a higher incidence of PPCs and received longer and more intense mechanical ventilation; however, only the duration of ventilation rather than intensity of ventilation or type of surgical approach (ie, RAS vs CLS) was independently associated with the occurrence of PPCs, indicating that the longer duration of ventilation in RAS underlies the higher incidence of PPCs observed in those who undergo this type of surgery.
Study context
- Population
- Adults requiring intraoperative ventilation during GA for conventional laparoscopic surgery (CLS) or robot-assisted surgery (RAS) abdominal procedures, 163 centres, 31 countries, 2013–2019 (LAS VEGAS and AVATaR studies)
- Participants
- 2,738 adults · 163 centres
- Exposure
- RAS vs CLS
- RASn = 903
- CLSn = 1,835reference
- Outcome
- Occurrence of ≥1 PPCs
- Follow-up
- First 5 postoperative days
Methodological detailspooled individual patient data of 2 prospective cohort studies, multicentre, international, mixed-effects logistic regression, mediation and matched cohort sensitivity analyses, Data collected January 2013 to March 2019; analysed December 2023 to October 2024
- Pooled individual patient data of 2 prospective cohort studies
- Multicentre
- International
- Mixed-effects logistic regression
- Mediation and matched cohort sensitivity analyses
- Data collected January 2013 to March 2019; analysed December 2023 to October 2024
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Duration of intraoperative ventilation
P < 0.001
Intensity of mechanical ventilation (4DP + RR)
P < 0.001
Factors independently associated with postoperative pulmonary complications (PPCs) (mixed-effects logistic regression)
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Duration of ventilation | 1.49 (1.33–1.66) | P < 0.001 | |
| Intensity of ventilation (4DP + RR) | 1.01 (1.01–1.01) | P = 0.21 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Factors independently associated with PPCs (mixed-effects logistic regression)RAS vs CLS | 1.35 (0.72–2.54) | P = 0.35 | |
| 0.20.5125Adjusted odds ratio (log scale) |
Intensity of ventilation by procedure duration (post hoc)
- More pronounced association of intensity of ventilation in shorter procedures
- Post hoc analysis
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →