Kim C W, Baik S H
Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine Seoul, Republic of Korea -
Minerva Chir. 2013 Oct;68(5):457-69.
Robotic rectal surgery is not a rare event for colorectal surgeons any more. Even patients with colorectal diseases obtain information through the mass media and are asking surgeons about robotic surgery. Since laparoscopic rectal surgery has proved to have some benefits compared to open rectal surgery, many surgeons became interested in robotic rectal surgery. Some of them have reported the advantages and disadvantages of robotic rectal surgery over the last decade. This review will report on the outcomes of robotic rectal surgery. Robotic rectal surgery requires a longer operation time than laparoscopic or open surgery, but many authors reduced the gap as they were accustomed to the robotic system and used various additional techniques. The high cost for purchasing and maintaining the robotic system is still a problem, though. However, except for this reason, robotic rectal surgery shows comparable and even superior results in some parameters than laparoscopic or open surgery. They include pathologic and functional outcomes as well as short-term outcomes such as complication rates, length of hospital stay, time to recover normal bowel function or first flatus, time to start diet, and postoperative pain. Moreover, studies on oncologic outcomes show acceptable results. Robotic rectal surgery is safe and feasible and has a number of benefits. Therefore, it can be an alternative option to conventional laparoscopic and open surgery with strict indications.
对于结直肠外科医生来说,机器人直肠手术已不再是罕见的手术方式。甚至患有结直肠疾病的患者也通过大众媒体获取信息,并向外科医生询问机器人手术相关情况。由于与开放直肠手术相比,腹腔镜直肠手术已被证明具有一些优势,许多外科医生对机器人直肠手术产生了兴趣。在过去十年中,他们中的一些人报告了机器人直肠手术的优缺点。本综述将报告机器人直肠手术的结果。机器人直肠手术比腹腔镜或开放手术需要更长的手术时间,但随着许多作者逐渐熟悉机器人系统并采用各种额外技术,他们缩小了这一差距。不过,购买和维护机器人系统的高昂成本仍是一个问题。然而,除此之外,机器人直肠手术在某些参数方面显示出与腹腔镜或开放手术相当甚至更优的结果。这些参数包括病理和功能结果以及短期结果,如并发症发生率、住院时间、恢复正常肠道功能或首次排气的时间、开始进食的时间以及术后疼痛。此外,关于肿瘤学结果的研究也显示出可接受的结果。机器人直肠手术安全可行且有诸多益处。因此,在严格的适应症下,它可以成为传统腹腔镜和开放手术的替代选择。