Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
Am J Surg. 2013 Oct;206(4):509-17. doi: 10.1016/j.amjsurg.2013.01.036. Epub 2013 Jun 27.
Robotic rectal cancer resection remains controversial. We compared the safety and efficacy of laparoscopic vs robotic rectal cancer resection in a high-risk Veterans Health Administration population.
Patients who underwent minimally invasive rectal cancer resection were identified from an institutional colorectal cancer database. Baseline characteristics and outcomes were compared between robotic and laparoscopic groups.
The robotic group (n = 13) did not differ significantly from the laparoscopic group (n = 59) with respect to baseline characteristics except for a higher rate of previous abdominal surgery. Robotic patients had significantly lower tumors, more advanced disease, a higher rate of preoperative chemoradiation, and were more likely to undergo abdominoperineal resection. Robotic rectal resection was associated with longer operative time. There were no differences in blood loss, conversion rates, postoperative morbidity, lymph nodes harvested, margin positivity, or specimen quality between groups.
The robotic approach for rectal cancer resection is safe with similar postoperative and oncologic outcomes compared with laparoscopy.
机器人直肠癌切除术仍存在争议。我们比较了高危退伍军人健康管理局人群中腹腔镜与机器人直肠癌切除术的安全性和疗效。
从机构结直肠癌数据库中确定接受微创直肠癌切除术的患者。比较机器人组和腹腔镜组的基线特征和结果。
机器人组(n=13)与腹腔镜组(n=59)在基线特征方面没有显著差异,除了既往腹部手术率较高。机器人患者的肿瘤较低,疾病更晚期,术前放化疗率较高,更有可能接受腹会阴联合切除术。机器人直肠切除术与手术时间延长有关。两组间出血量、转化率、术后发病率、淋巴结检出数、切缘阳性率和标本质量无差异。
与腹腔镜相比,机器人直肠癌切除术安全,术后和肿瘤学结果相似。