Yoon Sang Nam, Kim Kwang Yong, Kim Ji Won, Lee Seung Chul, Kwon Yong Jin, Cho Ji Woong, Jung So Young, Kim Byung Chun
Hepatogastroenterology. 2015 Jan-Feb;62(137):34-9.
BACKGROUND/AIMS: Robotic surgery is increasingly used for rectal cancer. We compared the short- and long-term outcomes between robotic- and laparoscopic-assisted resection for rectal cancer.
A retrospective chart review was performed between 2006 and 2010.
Seventeen robotic and 61 laparoscopic surgeries were performed consecutively. Median follow-up time was 58.2 months. No operation was converted to open surgery. No difference was observed between the groups for types of operations, diverting ileostomy rate, operation time, blood loss, and postoperative hospital stay, tumor diameter, distal margin, circumferential margin, tumor stage, differentiation, lymphovascular, or perineural invasion. However, the number of harvested lymph nodes was higher in the robot than that in the laparoscopy group (p = 0.017). Overall morbidity and reoperation rates were similar between the groups. The 5-yr overall and disease-free survival rates of all patients were 82.5% and 81.3%, respectively. The 5-yr overall and disease-free survival rates of the robotic and the laparoscopy groups were 94.1% and 79.7% (p = 0.241), and 94.1% and 77.9% (p = 0.159), respectively.
Robot-assisted resection for rectal cancer resulted in harvesting more lymph nodes without increasing morbidity and showed a comparable survival rate, compared with those of laparoscopy.
背景/目的：机器人手术在直肠癌治疗中的应用日益广泛。我们比较了机器人辅助与腹腔镜辅助直肠癌切除术的短期和长期疗效。
对2006年至2010年间的病历进行回顾性分析。
连续进行了17例机器人手术和61例腹腔镜手术。中位随访时间为58.2个月。无手术转为开放手术。两组在手术类型、转流性回肠造口率、手术时间、失血量、术后住院时间、肿瘤直径、远端切缘、环周切缘、肿瘤分期、分化程度、淋巴管或神经周围侵犯方面均未观察到差异。然而，机器人组获取的淋巴结数量高于腹腔镜组（p = 0.017）。两组的总体发病率和再次手术率相似。所有患者的5年总生存率和无病生存率分别为82.5%和81.3%。机器人组和腹腔镜组的5年总生存率和无病生存率分别为94.1%和79.7%（p = 0.241），以及94.1%和77.9%（p = 0.159）。
与腹腔镜手术相比，机器人辅助直肠癌切除术能获取更多淋巴结，且不增加发病率，生存率相当。
