Trinh Becky B, Hauch Adam T, Buell Joseph F, Kandil Emad
Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
JSLS. 2014 Oct-Dec;18(4). doi: 10.4293/JSLS.2014.00154.
Over the years, there has been a continual shift toward more minimally invasive surgical techniques, such as the use of laparoscopy in colorectal surgery. Recently, there has been increasing adoption of robotic technology. Our study aims to compare and contrast robot-assisted and laparoscopic approaches to colorectal operations.
Forty patients undergoing laparoscopic or robotic colorectal surgery performed by 2 surgeons at an academic center, regardless of indication, were included in this retrospective review. Patients undergoing open approaches were excluded. Study outcomes included operative time, estimated blood loss, length of stay, complications, and conversion rate to an open procedure.
Twenty-five laparoscopic and fifteen robot-assisted colorectal surgeries were performed. The mean patient age was 61.1 ± 10.7 years in the laparoscopic group compared with 61.1 ± 8.5 years in the robotic group (P = .997). Patients had a similar body mass index and history of abdominal surgery. Mean blood loss was 163.3 ± 249.2 mL and 96.8 ± 157.7 mL, respectively (P = .385). Operative times were similar, with 190.8 ± 84.3 minutes in the laparoscopic group versus 258.4 ± 170.8 minutes in the robotic group (P = .183), as were lengths of hospital stay: 9.6 ± 7.3 and 6.5 ± 3.8 days, respectively (P = .091). In addition, there was no difference in the number of lymph nodes harvested between the laparoscopic group (14.0 ± 6.5) and robotic group (12.3 ± 4.2, P = .683).
In our early experience, the robotic approach to colorectal surgery can be considered both safe and efficacious. Furthermore, it also preserves oncologically sufficient outcomes when performed for cancer operations.
多年来，外科手术技术持续朝着更微创的方向发展，比如在结直肠手术中使用腹腔镜技术。近来，机器人技术的应用越来越广泛。我们的研究旨在比较和对比机器人辅助与腹腔镜两种结直肠手术方式。
本回顾性研究纳入了40例在学术中心由2名外科医生进行腹腔镜或机器人辅助结直肠手术的患者，手术指征不限。接受开放手术的患者被排除。研究结果包括手术时间、估计失血量、住院时间、并发症以及转为开放手术的比例。
共进行了25例腹腔镜结直肠手术和15例机器人辅助结直肠手术。腹腔镜组患者的平均年龄为61.1±10.7岁，机器人组为61.1±8.5岁（P = 0.997）。患者的体重指数和腹部手术史相似。平均失血量分别为163.3±249.2毫升和96.8±157.7毫升（P = 0.385）。手术时间相似，腹腔镜组为190.8±84.3分钟，机器人组为258.4±170.8分钟（P = 0.183），住院时间也相似，分别为9.6±7.3天和6.5±3.8天（P = 0.091）。此外，腹腔镜组（14.0±6.5）和机器人组（12.3±4.2，P = 0.683）之间的淋巴结清扫数量没有差异。
根据我们的早期经验，机器人辅助结直肠手术可被认为是安全有效的。此外，在进行癌症手术时，它也能保证肿瘤学上足够的手术效果。
