Tu1591 Learning Curve for Combined Thoracoscopic and Laparoscopic Robotic-Assisted Minimally Invasive Esophagectomy Using a Four-Arm Platform

Abstract

antibiotic therapy for CDI followed by total abdominal colectomy and end ileostomy; Group B (n=21); who underwent upfront surgery without any delay for antibiotics. Demographics, comorbidities, body mass index (BMI) and UC-related parameters were compared. Intraoperative complications, the need for intensive care unit stay (ICU), mortality, 30-day reoperation and readmission rates, surgical site infection rate (SSI), return to bowel function and were assessed. The impact of two different approaches on future restorative attempts was also evaluated. Results: Both groups were similar in terms of demographics, BMI, comorbidities, medical treatment of UC, operation time, estimated blood loss and ICU requirement. There was no statistically difference in terms of wound infection [(30.8% vs. 9.5%), p=0.11], ileus [(30.8% vs. 14.3%), p=0.25], return to bowel function [2.23 (±1.8) vs. 2.14 (±1.3) days; p=0.73], reoperation [1 (7.7%) vs. 2 (9.5%), p=0.85] and readmission rates [0 vs. 2 (9.5%), p=0.15]. Intraoperative splenic injury was observed in one (7.7%) patient in group A (p= 0.16). Restorative proctocolectomy was completed for 9 (69.2%) patients in group A and in 18 (85.7%) patients in group B within a follow-up time of 12 month (p=0.25). Conclusion: Early colectomy can safely be performed in patients with medically refractory ulcerative colitis superimposed by Clostridium difficile infection with no difference in postoperative complications. Further randomized studies may potentially reveal superiority of upfront surgery. Table. Characteristics and outcomes of patients who underwent early or delay surgery