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直肠癌的机器人手术:当前实践的系统评价。

Robotic surgery for rectal cancer: A systematic review of current practice.

机构信息

Tony Wing Chung Mak, Janet Fung Yee Lee, Sophie Sok Fei Hon, Dennis Kwok Yu Ngo, Simon Siu Man Ng, Division of Colorectal Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.

出版信息

World J Gastrointest Oncol. 2014 Jun 15;6(6):184-93. doi: 10.4251/wjgo.v6.i6.184.

Abstract

AIM

To give a comprehensive review of current literature on robotic rectal cancer surgery.

METHODS

A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: "robotic surgery", "surgical robotics", "laparoscopic computer-assisted surgery", "colectomy" and "rectal resection".

RESULTS

After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m(2) were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann's operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery.

CONCLUSION

Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.

摘要

目的

对目前有关机器人直肠癌手术的文献进行全面综述。

方法

通过 PubMed 和 Embase 搜索引擎对当前文献进行系统综述,以确定 2007 年 1 月至 2013 年 11 月的相关文章。使用的关键词为:“机器人手术”、“手术机器人”、“腹腔镜计算机辅助手术”、“结肠切除术”和“直肠切除术”。

结果

在初步筛选了 380 篇文章后,选择了 20 篇文章进行综述。共有 1062 例患者(男性 64.0%)纳入研究,平均年龄为 61.1 岁,体重指数为 24.9kg/m(2)。在 1062 例机器人辅助手术中,831 例(78.2%)为前位和低位前切除术,132 例(12.4%)为经肛括约肌间切除术和结肠肛管吻合术,98 例(9.3%)为腹会阴联合切除术,1 例(0.1%)为 Hartmann 手术。与腹腔镜直肠手术相比,机器人直肠手术虽然手术时间较长,但在肿瘤学结果和吻合口漏发生率方面具有可比性。

结论

机器人结直肠手术不断发展,取得了良好的效果,是一种可行的手术方法,其转换率低,短期肿瘤学结果相当。机器人手术面临的挑战是需要更多高质量的研究来证明其成本效益。

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