International multicenter observational study on assessment of ventilatory management during general anaesthesia for robotic surgery and its effects on postoperative pulmonary complication (AVATaR): study protocol and statistical analysis plan.
INTRODUCTION
Robotic-assisted surgery (RAS) has emerged as an alternative minimally invasive surgical option. Despite its growing applicability, the frequent need for pneumoperitoneum and Trendelenburg position could significantly affect respiratory mechanics during RAS. AVATaR is an international multicenter observational study aiming to assess the incidence of postoperative pulmonary complications (PPC), to characterise current practices of mechanical ventilation (MV) and to evaluate a possible association between ventilatory parameters and PPC in patients undergoing RAS.


METHODS AND ANALYSIS
AVATaR is an observational study of surgical patients undergoing MV for general anaesthesia for RAS. The primary outcome is the incidence of PPC during the first five postoperative days. Secondary outcomes include practice of MV, effect of surgical positioning on MV, effect of MV on clinical outcome and intraoperative complications.


ETHICS AND DISSEMINATION
This study was approved by the Institutional Review Board of the Hospital Israelita Albert Einstein. The study results will be published in peer-reviewed journals and disseminated at international conferences.


TRIAL REGISTRATION NUMBER
NCT02989415; Pre-results.
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D000768:Anesthesia, General D006801:Humans D008171:Lung Diseases D015337:Multicenter Studies as Topic D064887:Observational Studies as Topic D011183:Postoperative Complications D012121:Respiration, Artificial D065287:Robotic Surgical Procedures
robotic surgery postoperative pulmonary complications mechanical ventilation general anesthesia