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与传统腹腔镜手术相比,机器人技术在右半结肠切除术中进行体内吻合时具有优势。

Robotics confers an advantage in right hemicolectomy with intracorporeal anastomosis when matched against conventional laparoscopy.

作者信息

Ngu James Chi-Yong, Ng Yvonne Ying-Ru

机构信息

Department of General Surgery, Changi General Hospital, 2, Simei Street 3, Singapore, 529889, Singapore.

出版信息

J Robot Surg. 2018 Dec;12(4):647-653. doi: 10.1007/s11701-018-0793-6. Epub 2018 Feb 22.

Abstract

Comparisons between robotic and laparoscopic right hemicolectomy have been confounded by variations in operative technique. This study evaluates the two procedures after standardizing the intraoperative steps and perioperative management. Patients who underwent robotic right hemicolectomy with intracorporeal bowel anastomosis between July 2015 and June 2017 were matched with a laparoscopic group. Perioperative management was in accordance to an enhanced recovery protocol. Outcomes and histopathological data were compared. Thirty-two patients were included. Amongst the patients who did not undergo complete mesocolic excision, the median operative time did not differ between the two groups (p = 0.413). The robotic group recorded a statistically shorter time for intracorporeal anastomosis (13 vs 19 min, p = 0.024). Postoperative recovery and complication rates were similar, except for a greater lymph node harvest in the robotic group (41 vs 31, p = 0.038). Robotic surgery achieves short-term results comparable to existing conventional laparoscopy, notwithstanding the advantages of enhanced ergonomics.

摘要

机器人辅助与腹腔镜下右半结肠切除术的比较因手术技术的差异而受到干扰。本研究在规范术中步骤和围手术期管理后对这两种手术进行评估。2015年7月至2017年6月期间接受机器人辅助右半结肠切除术并行体内肠吻合术的患者与腹腔镜组进行匹配。围手术期管理遵循强化康复方案。比较了两组的手术结果和组织病理学数据。共纳入32例患者。在未进行完整结肠系膜切除术的患者中,两组的中位手术时间无差异(p = 0.413)。机器人辅助组的体内吻合时间在统计学上更短(13分钟对19分钟,p = 0.024)。除机器人辅助组获取的淋巴结更多(41枚对31枚,p = 0.038)外,两组术后恢复情况和并发症发生率相似。尽管机器人辅助手术在人体工程学方面具有优势,但其短期手术效果与现有的传统腹腔镜手术相当。

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