Department of Surgery, University of Chicago Medical Center and The University of Chicago Inflammatory Bowel Disease Center, 5841 S. Maryland Ave, MC 5095, Chicago, IL 60637, USA.
J Gastrointest Surg. 2012 Mar;16(3):587-94. doi: 10.1007/s11605-011-1692-6. Epub 2011 Oct 1.
The objective of this study was to compare short-term outcomes of robotic and laparoscopic proctectomy in patients with inflammatory bowel disease (IBD).
This is an IRB-approved case-matched review. Seventeen robotic proctectomies (RP), 10 with ileal pouch anal anastomosis (IPAA) and 7 completion (CP), were matched to laparoscopic proctectomies (LP). Short-term and functional outcomes were compared between LP and RP.
In CP cohort, operative times were longer in the RP group (351 RP vs 238 LP min, p = 0.03), mean robotic time 90 min. Estimated blood loss (EBL) was similar between RP-CP and LP-CP groups (p = 0.18). Return of bowel function (RBF) was slower in RP-CP group (3.0 vs 1.7 days, p = 0.04), and length of stay (LOS) was longer (6.4 vs 4.1 days, p = 0.02). In the IPAA group, there were no differences between operative times (p = 0.14), robotic time 86 min; EBL (p = 0.15), and postoperative complications. Return of bowel function (3.6 vs 2.6 days, p = 0.3) and LOS (8.5 vs 6.1 days, p = 0.17) were similar between RP and LP. Bowel and sexual function were equivalent between LP and RP-IPAA groups.
Robotic proctectomy is a safe and effective technique for patients with IBD. It is comparable to LP with regard to perioperative outcomes, complications, and short-term functional results.
本研究旨在比较机器人与腹腔镜直肠切除术治疗炎症性肠病（IBD）患者的短期疗效。
这是一项经过 IRB 批准的病例匹配回顾性研究。共纳入 17 例行机器人直肠切除术（RP）的患者，其中 10 例行回肠贮袋肛管吻合术（IPAA），7 例行完成式直肠切除术（CP），并与腹腔镜直肠切除术（LP）进行匹配。比较 LP 与 RP 的短期和功能结果。
在 CP 组中，RP 组的手术时间更长（351 vs 238 min，p = 0.03），机器人操作时间为 90 min。RP-CP 组和 LP-CP 组的估计失血量（EBL）相似（p = 0.18）。RP-CP 组的肠道功能恢复（RBF）较慢（3.0 天 vs 1.7 天，p = 0.04），住院时间（LOS）较长（6.4 天 vs 4.1 天，p = 0.02）。在 IPAA 组中，手术时间无差异（p = 0.14），机器人操作时间为 86 min；EBL 无差异（p = 0.15），术后并发症也无差异。RBF（3.6 天 vs 2.6 天，p = 0.3）和 LOS（8.5 天 vs 6.1 天，p = 0.17）在 RP 和 LP 之间相似。LP 和 RP-IPAA 组的肠道和性功能相似。
机器人直肠切除术是治疗 IBD 患者的一种安全有效的技术。与 LP 相比，RP 在围手术期结局、并发症和短期功能结果方面相当。
