Enhanced recovery after surgery may mitigate the risks associated with robotic-assisted fundoplication in lung transplant patients

Rebecca Wu, Valeria Robayo, Duc T. Nguyen, Edward Y. Chan, Ray Chihara, Howard J. Huang, Edward A. Graviss, Min P. Kim

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: A history of lung transplantation is a risk factor for poor outcomes in patients undergoing laparoscopic fundoplication. We wanted to determine whether enhanced recovery after a robotic-assisted surgery program would mitigate these risks. Methods: We performed a single-center retrospective analysis of the Society of Thoracic Surgery database for patients who underwent elective antireflux procedures from 1/2018 to 2/2021 under the enhanced recovery after surgery program using robotic assistance. We identified the patient and surgical characteristics, morbidity, length of stay, and 30-day readmission rates. Results: Among 386 patients who underwent barrier creation, 41 had previously undergone a lung transplant, either bilateral (n = 28) or single (n = 13). There were no significant differences in postoperative complications (9.8% vs. 5.2%, p = 0.27), median hospital length of stay (1 d vs. 1 d, p = 0.28), or 30-day readmission (7.3% vs. 4.9%, p = 0.46). Bivariate analysis showed that older age (p = 0.03), history of DVT/PE (p < 0.001), history of cerebrovascular events (p = 0.03), opioid dependence (p = 0.02), neurocognitive dysfunction (p < 0.001), and dependent functional status (p = 0.02) were associated with postoperative complications. However, lung transplantation was not associated with an increased risk of postoperative complications (p = 0.28). Discussion: The risk of surgical complications in patients with a history of lung transplantation may be mitigated by the combination of ERAS and minimally invasive surgery such as robot-assisted surgery.

Original languageEnglish (US)
Pages (from-to)2134-2141
Number of pages8
JournalSurgical Endoscopy
Volume38
Issue number4
DOIs
StatePublished - Apr 2024

Keywords

  • ERAS
  • Fundoplication
  • Lung transplant
  • Outcomes
  • Robot assisted laparoscopic surgery

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Enhanced recovery after surgery may mitigate the risks associated with robotic-assisted fundoplication in lung transplant patients'. Together they form a unique fingerprint.

Cite this