Improved outcomes with robotic-assisted laparoscopic paraesophageal hernia repairs compared with laparoscopic and transthoracic approaches: A single high-volume institution experience

摘要

Objectives: Laparoscopic (lap) paraesophageal hernia repair has excellent short-term outcomes but higher long-term recurrence rates compared with the transthoracic repair. We hypothesized that the robotic-assisted lap (robot) approach would have similarly good short-term outcomes as lap, but also lower recurrence rates. Methods: A retrospective study of prospectively collected data was performed for paraesophageal hernia repairs at a single high-volume quaternary hospital from July 2018 to September 2022. Outcomes analyzed included 2-year postoperative radiographic recurrence (Rad), Society of Thoracic Surgeons-defined radiographic recurrence (STS-rad), symptomatic recurrence (Sx), and perioperative outcomes. Lap, robot, and transthoracic groups were compared using univariate, multivariate, and propensity score analysis. Results: < .05). Conclusions: Robotic paraesophageal hernia repairs had generally lower 2-year recurrence and reoperation than lap and shorter hospital stays and fewer immediate complications than transthoracic.