Yamaguchi Tomohiro, Kinugasa Yusuke, Shiomi Akio, Tomioka Hiroyuki, Kagawa Hiroyasu, Yamakawa Yushi
Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Surg Today. 2016 Aug;46(8):957-62. doi: 10.1007/s00595-015-1266-4. Epub 2015 Oct 19.
Several retrospective studies have demonstrated the safety and technical feasibility of robotic-assisted laparoscopic surgery (RALS). The aim of the present study was to clarify the advantages of RALS for rectal cancer by comparing its short-term outcomes with those of conventional laparoscopic surgery (CLS).
Between April, 2010 and April, 2015, a total of 974 patients underwent proctectomy for rectal cancer. After the exclusion of those who underwent open surgery, high anterior resection, lateral lymph node dissection, or multiple resection, 442 patients were enrolled in this study, including 203 who underwent RALS and 239 who underwent CLS. We compared the short-term outcomes of these two groups.
There was no case of conversion to open surgery in the RALS group, but 8 (3.3 %) cases in the CLS group (p = 0.009). Operative time was not significantly different, but blood loss was significantly less in the RALS group than in the CLS group (p < 0.001). The postoperative hospital stay was shorter in the RALS group than in the CLS group (p < 0.001). The rate of urinary retention was significantly lower in the RALS group than in the CLS group (p = 0.018).
The short-term outcomes in this series provide further evidence that RALS may be superior to CLS for rectal cancer.
多项回顾性研究已证实机器人辅助腹腔镜手术(RALS)的安全性和技术可行性。本研究的目的是通过比较RALS与传统腹腔镜手术(CLS)的短期结果,阐明RALS在直肠癌治疗中的优势。
2010年4月至2015年4月期间,共有974例患者接受了直肠癌直肠切除术。在排除接受开放手术、高位前切除术、侧方淋巴结清扫术或多次切除术的患者后,本研究纳入了442例患者,其中203例接受了RALS,239例接受了CLS。我们比较了这两组的短期结果。
RALS组无1例转为开放手术,而CLS组有8例(3.3%)(p = 0.009)。手术时间无显著差异,但RALS组的失血量明显少于CLS组(p < 0.001)。RALS组的术后住院时间比CLS组短(p < 0.001)。RALS组的尿潴留发生率明显低于CLS组(p = 0.018)。
本系列的短期结果进一步证明,RALS在直肠癌治疗方面可能优于CLS。