Baik S H, Ko Y T, Kang C M, Lee W J, Kim N K, Sohn S K, Chi H S, Cho C H
Robotic and Laparoscopic Surgery Center, Severance Hospital, Seoul, Korea.
Surg Endosc. 2008 Jul;22(7):1601-8. doi: 10.1007/s00464-008-9752-z. Epub 2008 Feb 13.
Laparoscopic colorectal resection has become popular. The recently developed da Vinci Surgical System promises to facilitate endoscopic surgery and overcome its disadvantages. This study therefore aimed to compare the short-term results between robotic tumor-specific mesorectal excision (R-TSME) using the da Vinci Surgical System and conventional laparoscopic tumor-specific mesorectal excision (L-TSME) in rectal cancer patients.
Between April 2006 and February 2007, 36 patients were randomly assigned to receive R-TSME or L-TSME. During the study, 18 patients underwent robotic low anterior resection using the da Vinci Surgical System, and 18 patients had conventional laparoscopic low anterior resection. Patient characteristics, perioperative clinical results, complications, and pathologic details were compared between the two groups.
The patient characteristics were not significantly different between the two groups. The mean operating time, hemoglobin change, and conversion rate were not significantly different between the groups. Complications were treated conservatively and did not require surgical intervention in the R-TSME group. The average length of stay was 6.9 +/- 1.3 days in the R-TSME group and 8.7 +/- 1.3 days in the L-TSME group (p < 0.001). The specimen quality of the R-TSME group was acceptable.
Tumor-specific mesorectal excision was performed safely and effectively using the da Vinci Surgical System and the perioperative outcomes were acceptable.
腹腔镜结直肠癌切除术已变得流行。最近研发的达芬奇手术系统有望促进内镜手术并克服其缺点。因此，本研究旨在比较使用达芬奇手术系统的机器人肿瘤特异性直肠系膜切除术（R-TSME）与传统腹腔镜肿瘤特异性直肠系膜切除术（L-TSME）在直肠癌患者中的短期结果。
2006年4月至2007年2月期间，36例患者被随机分配接受R-TSME或L-TSME。研究期间，18例患者使用达芬奇手术系统进行机器人低位前切除术，18例患者进行传统腹腔镜低位前切除术。比较两组患者的特征、围手术期临床结果、并发症及病理细节。
两组患者特征无显著差异。两组的平均手术时间、血红蛋白变化及中转率无显著差异。R-TSME组并发症经保守治疗，无需手术干预。R-TSME组平均住院时间为6.9±1.3天，L-TSME组为8.7±1.3天（p<0.001）。R-TSME组标本质量可接受。
使用达芬奇手术系统进行肿瘤特异性直肠系膜切除术安全有效，围手术期结果可接受。
