부산대학교 도서관

Objectives: Robot-assisted vaginal vault suspension (RAWS) for pelvic organ prolapse (POP) represents a minimally-invasive alter-native to abdominal sacrocolpopexy. We measured perioperative outcomes and utilization rates of RAWS. Methods: RAWS (n = 2381 ) and open WS (OVVS, n = 11080) data were extracted from the 2009-2010 Nationwide Inpatient Sample. Propensity score-matched analysis compared patients undergoing RAWS or OVVS for complications, mortality, prolonged length-of-stay, and elevated hospital charges. Results: Use of RAWS for POP increased from 2009 to 2010 (16.3% to 19.2%). Patients undergoing RAWS were more likely to be white (77.2% vs. 69.6%), to carry private insurance (52.8% vs. 46.0%) and to have fewer comorbidities (Charlson Comorbidity Index [CCI] >1 = 17.5% vs. 26.6%). They were more likely to undergo surgery at urban (98.2% vs. 93.7%) and academic centres (75.7% vs. 56.7%). Patients undergoing RAWS were less likely to receive a blood-transfusion (0.7% vs. 1.8%, p < 0.001 ) or experi-ence prolonged length-of-stay (9.3% vs. 25.1%, p < 0.001). They had more intraoperative complications (6.0% vs. 4.2%, p < 0.001 ), and higher median hospital charges ($32 402 vs. $24 136, p < 0.001). Overall postoperative complications were equivalent (17.9%, p = 1.0), though there were differences in wound (0.4% vs. 1.3%, p < 0.001), genitourinary (4.9% vs. 6.5%, p = 0.009), and surgical (6.6% vs. 4.9%, p = 0.007) complications. Conclusions: The increasing use of RAWS from 2009 to 2010 suggests a growth in the adoption of robotics to manage POP. We show that RAWS is associated with decreased length of stay, fewer blood transfusions, as well as lower postoperative wound, genitourinary and vascular complications. The benefits of RAWS are mitigated by higher hospital charges and higher rates of intra-operative complications. [ABSTRACT FROM AUTHOR]