102 例连续的机器人辅助微创结肠切除术——结果和技术更新。
One hundred and two consecutive robotic-assisted minimally invasive colectomies--an outcome and technical update.
机构信息
Division of Minimally Invasive Surgery, Department of Surgery, University of Illinois College of Medicine at Peoria/OSF St. Frances Hospital, 1001 Main Street, Suite 300, Peoria, IL 61606, USA.
出版信息
J Gastrointest Surg. 2011 Jul;15(7):1195-204. doi: 10.1007/s11605-011-1549-z. Epub 2011 May 21.
BACKGROUND
The objective of this study was to review 102 consecutive robotic colectomies at our institution. We evaluated the 8-year experience of one surgeon (DLC) in Peoria, IL using the da Vinci system.
METHODS
An IRB-approved retrospective review was performed. Results were compared with the literature. Changes in technique over the years were evaluated.
RESULTS
One hundred and two robotic colectomies, right (59) and sigmoid (43), were performed. Mean age is 63.5 years and mean BMI 27.4 kg/m². Preoperative indications are polyps (53), diverticular disease (27), cancer (19), and carcinoid (3). Mean total case time (TCT) for all cases is 219.6 ± 45.1 (50-380) min, and mean robot operating time (ROT) is 126.6 ± 41.6 (12-306) min. Operative times for Right: Port setup time (PST) 32.4 ± 10.5 (20-64) min, ROT 145.2 ± 39.6 (53-306) min, TCT 212.3 ± 46.4 (50-380) min; times for sigmoid: PST 31.2 ± 9.6 (10-57) min, ROT 101.2 ± 29.2 (12-165) min, TCT 229.7 ± 41.6 (147-323) min. Median length of stay for all patients is 3 (2-27) days. The overall complication rate is 18.6%, the overall conversion rate 8.8%, and the anastomotic leak rate is 0.98%. Residents PGY 1-5 participated in 61 cases (59.8%).
CONCLUSION
We report our updated procedural sequence and technical alterations. Experience has allowed residents to evolve to be primary surgeons. We add our results to the current robotic literature.
背景
本研究旨在回顾本机构连续 102 例达芬奇机器人结肠切除术的经验。我们评估了在伊利诺伊州皮奥里亚的一位外科医生（DLC）使用达芬奇系统 8 年的经验。
方法
进行了一项经过机构审查委员会批准的回顾性研究。将结果与文献进行比较。评估了多年来技术的变化。
结果
共完成 102 例机器人右半结肠（59 例）和乙状结肠切除术（43 例）。患者平均年龄为 63.5 岁，平均 BMI 为 27.4kg/m²。术前指征为息肉（53 例）、憩室病（27 例）、癌症（19 例）和类癌（3 例）。所有病例的总手术时间（TCT）平均值为 219.6±45.1（50-380）分钟，机器人手术时间（ROT）平均值为 126.6±41.6（12-306）分钟。右半结肠手术时间：端口设置时间（PST）为 32.4±10.5（20-64）分钟，ROT 为 145.2±39.6（53-306）分钟，TCT 为 212.3±46.4（50-380）分钟；乙状结肠手术时间：PST 为 31.2±9.6（10-57）分钟，ROT 为 101.2±29.2（12-165）分钟，TCT 为 229.7±41.6（147-323）分钟。所有患者的中位住院时间为 3（2-27）天。总的并发症发生率为 18.6%，总的中转率为 8.8%，吻合口漏的发生率为 0.98%。住院医师 PGY1-5 参与了 61 例手术（59.8%）。
结论
我们报告了我们更新的手术步骤和技术改变。经验使住院医师能够成为主要手术医生。我们将结果添加到现有的机器人文献中。
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