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机器人辅助低位前切除术与经肛门全直肠系膜切除术治疗直肠癌的比较:115 例病例分析。

Robotic low anterior resection versus transanal total mesorectal excision in rectal cancer: A comparison of 115 cases.

机构信息

Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.

出版信息

Eur J Surg Oncol. 2018 Feb;44(2):237-242. doi: 10.1016/j.ejso.2017.11.011. Epub 2017 Nov 26.

Abstract

BACKGROUND

Robotic low anterior resection (RLAR) and transanal total mesorectal excision (TaTME) are novel surgical techniques for resection of rectal cancer. To our knowledge, no data exist on direct comparison of these procedures in terms of oncological or functional parameters.

METHODS

60 RLAR and 55 TaTME for rectal cancer were compared in respect to patient characteristics, clinicopathological parameters, intraoperative and perioperative results and anatomopathological outcome.

RESULTS

62 surgeries addressed tumors of the lower third (53.9%). No intergroup differences in terms of patient characteristics and clinicopathological parameters were observed. Operating time did not differ between groups (p = 0.312), nor did the perioperative complication rate (p = 0.176). Circumferential resection margin was wider in the RLAR than in the TaTME group (p < 0.001), while no differences were found in the remaining oncological parameters.

CONCLUSION

Our study shows comparable results for RLAR and TaTME in rectal cancer treatment. Both procedures should be considered equally feasible for low rectal cancer cases and as an alternative to conventional anterior resections (open or laparoscopic). Furthermore, both techniques allow excellent oncological outcome especially in patients with anatomical limitations.

摘要

背景

机器人低位前切除术(RLAR)和经肛门全直肠系膜切除术(TaTME)是直肠肿瘤切除的新型手术技术。据我们所知,目前尚无关于这些手术在肿瘤学或功能参数方面直接比较的数据。

方法

我们比较了 60 例 RLAR 和 55 例 TaTME 治疗直肠肿瘤的患者特征、临床病理参数、术中及围手术期结果和解剖病理结果。

结果

62 例手术均为低位直肠肿瘤(53.9%)。两组患者的特征和临床病理参数无差异。两组手术时间无差异(p=0.312),围手术期并发症发生率也无差异(p=0.176)。RLAR 组的环周切缘比 TaTME 组宽(p<0.001),但其余肿瘤学参数无差异。

结论

我们的研究表明 RLAR 和 TaTME 在直肠肿瘤治疗中具有相似的结果。这两种方法都可以认为是低位直肠肿瘤病例的同样可行的治疗方法,并且可以替代传统的前切除术(开放或腹腔镜)。此外,这两种技术都能提供良好的肿瘤学结果,特别是对于解剖学限制的患者。

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