机器人直肠全系膜切除术治疗直肠癌 71 例单中心分析。
Robotic proctectomy for rectal cancer: analysis of 71 patients from a single institution.
机构信息
Department of Surgery, University of Iowa, Iowa City, IA, USA.
Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
出版信息
Int J Med Robot. 2017 Dec;13(4). doi: 10.1002/rcs.1841. Epub 2017 Jun 1.
BACKGROUND
Despite increasing use of robotic surgery for rectal cancer, few series have been published from the practice of generalizable US surgeons.
METHODS
A retrospective chart review was performed for 71 consecutive patients who underwent robotic low anterior resection (LAR) or abdominoperineal resection (APR) for rectal adenocarcinoma between 2010 and 2014.
RESULTS
46 LARs (65%) and 25 APRs (35%) were identified. Median procedure time was 219 minutes (IQR 184-275) and mean blood loss 164.9 cc (SD 155.9 cc). Radial margin was negative in 70/71 (99%) patients. Total mesorectal excision integrity was complete/near complete in 38/39 (97%) of graded specimens. A mean of 16.8 (SD+/- 8.9) lymph nodes were retrieved. At median follow-up of 21.9 months, there were no local recurrences.
CONCLUSIONS
Robotic proctectomy for rectal cancer was introduced into typical colorectal surgery practice by a single surgeon, with a low conversion rate, low complication rate, and satisfactory oncologic outcomes.
背景
尽管直肠肿瘤的机器人手术应用日益增多，但美国普通外科医生的实践中发表的相关系列研究较少。
方法
对 2010 年至 2014 年间连续 71 例接受直肠腺癌机器人低位前切除术（LAR）或腹会阴切除术（APR）的患者进行回顾性图表审查。
结果
共行 46 例 LAR（65%）和 25 例 APR（35%）。中位手术时间为 219 分钟（IQR 184-275），平均失血量为 164.9cc（SD 155.9cc）。71 例患者中有 70 例（99%）的直肠环周切缘阴性。38/39 例（97%）分级标本的全直肠系膜切除完整性完整/接近完整。平均取 16.8（SD+/-8.9）个淋巴结。中位随访 21.9 个月，无局部复发。
结论
一名外科医生将机器人直肠切除术引入典型的结直肠手术实践中，其转化率低、并发症发生率低，且肿瘤学结果令人满意。
Zotero 插件