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机器人辅助与腹腔镜下直肠癌低位前切除术:一项前瞻性比较研究的短期结果

Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study.

作者信息

Baik Seung Hyuk, Kwon Hye Youn, Kim Jin Soo, Hur Hyuk, Sohn Seung Kook, Cho Chang Hwan, Kim Hoguen

机构信息

Department of Surgery, Yonsei University College of Medicine, Shinchon-dong, Seodaemun-ku, Seoul, Korea.

出版信息

Ann Surg Oncol. 2009 Jun;16(6):1480-7. doi: 10.1245/s10434-009-0435-3. Epub 2009 Mar 17.

Abstract

BACKGROUND

The aim of this study is to compare the short-term results between robotic-assisted low anterior resection (R-LAR), using the da Vinci Surgical System, and standard laparoscopic low anterior resection (L-LAR) in rectal cancer patients.

METHODS

113 patients were assigned to receive either R-LAR (n = 56) or L-LAR (n = 57) between April 2006 and September 2007. Patient characteristics, perioperative clinical results, complications, and pathologic details were compared between the groups. Moreover, macroscopic grading of the specimen was evaluated.

RESULTS

Patient characteristics were not significantly different between the groups. The mean operation time was 190.1 +/- 45.0 min in the R-LAR group and 191.1 +/- 65.3 min in the L-LAR group (P = 0.924). The conversion rate was 0.0% in the R-LAR groups and 10.5% in the L-LAR group (P = 0.013). The serious complication rate was 5.4% in the R-LAR group and 19.3% in the L-LAR group (P = 0.025). The specimen quality was acceptable in both groups. However, the mesorectal grade was complete (n = 52) and nearly complete (n = 4) in the R-LAR group and complete (n = 43), nearly complete (n = 12), and incomplete (n = 2) in the L-LAR group (P = 0.033).

CONCLUSION

R-LAR was performed safely and effectively, using the da Vinci Surgical System. The use of the system resulted in acceptable perioperative outcomes compared to L-LAR.

摘要

背景

本研究旨在比较使用达芬奇手术系统的机器人辅助低位前切除术(R-LAR)与直肠癌患者的标准腹腔镜低位前切除术(L-LAR)的短期结果。

方法

2006年4月至2007年9月期间,113例患者被分配接受R-LAR(n = 56)或L-LAR(n = 57)。比较两组患者的特征、围手术期临床结果、并发症和病理细节。此外,对标本的宏观分级进行评估。

结果

两组患者特征无显著差异。R-LAR组平均手术时间为190.1±45.0分钟,L-LAR组为191.1±65.3分钟(P = 0.924)。R-LAR组的转换率为0.0%,L-LAR组为10.5%(P = 0.013)。R-LAR组严重并发症发生率为5.4%,L-LAR组为19.3%(P = 0.025)。两组标本质量均可接受。然而,R-LAR组直肠系膜分级为完整(n = 52)和近完整(n = 4),L-LAR组为完整(n = 43)、近完整(n = 12)和不完整(n = 2)(P = 0.033)。

结论

使用达芬奇手术系统安全有效地进行了R-LAR。与L-LAR相比,该系统的使用导致了可接受的围手术期结果。

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