Erguner Ilknur, Aytac Erman, Boler Deniz Eren, Atalar Banu, Baca Bilgi, Karahasanoglu Tayfun, Hamzaoglu Ismail, Uras Cihan
Department of Surgery, Acibadem University School of Medicine, Istanbul, Turkey.
Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):316-9. doi: 10.1097/SLE.0b013e31828e3697.
Robotic surgery is thought to be a solution to overcome the limitations of laparoscopy in sphincter-saving resections. In this study, we present our results on patients undergoing robotic and laparoscopic low anterior resection (LAR) consecutively for rectal adenocarcinoma.
Between February 2008 and June 2011, consecutive patients who underwent laparoscopic or robotic LAR by a single surgical team for rectal cancer were evaluated. The patients' demographic, operative, postoperative short-term follow-up, and histopathologic data were analyzed.
Twenty-seven patients underwent robotic LAR, whereas 37 patients underwent laparoscopic LAR. The operation time of the laparoscopy group was significantly shorter than that of the robotic group (P=0.02). The complete total mesorectal excision rate was significantly higher in the robotic group (P=0.02). The overall complication rates were 11.11% and 21.62% in the robotic and laparoscopy groups, respectively (P=0.45).
Good quality of resected specimens could be achieved with robotic LAR. Further prospective studies including long-term oncologic outcomes and costs with higher patient number are definitely needed to assess the benefits of robotic resection in rectal cancer treatment.
机器人手术被认为是克服腹腔镜保肛切除术局限性的一种解决方案。在本研究中，我们展示了连续接受机器人辅助和腹腔镜低位前切除术（LAR）治疗直肠腺癌患者的结果。
对2008年2月至2011年6月期间由同一手术团队连续接受腹腔镜或机器人辅助LAR治疗直肠癌的患者进行评估。分析患者的人口统计学、手术、术后短期随访及组织病理学数据。
27例患者接受机器人辅助LAR，37例患者接受腹腔镜LAR。腹腔镜组的手术时间显著短于机器人组（P = 0.02）。机器人组的完整直肠系膜全切除率显著更高（P = 0.02）。机器人组和腹腔镜组的总体并发症发生率分别为11.11%和21.62%（P = 0.45）。
机器人辅助LAR可获得高质量的切除标本。绝对需要进一步开展前瞻性研究，纳入更多患者，包括长期肿瘤学结局和成本，以评估机器人切除术在直肠癌治疗中的益处。
