Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, School of Medicine, Istanbul, Turkey.
School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
J Robot Surg. 2019 Feb;13(1):107-114. doi: 10.1007/s11701-018-0817-2. Epub 2018 May 17.
Complexity and operative risks of complete mesocolic excision (CME) seem to be important drawbacks to generalize this procedure in the surgical treatment of right colon cancer. Robotic systems have been developed to improve quality and outcomes of minimal invasive surgery. The aim of this study was to evaluate the feasibility of robotic right-sided CME and present our initial experience. A retrospective review of 37 patients undergoing totally robotic right-sided CME between February 2015 and November 2017 was performed. All the operations were carried out using the key principles of both CME with intracorporeal anastomosis and no-touch technique. Data on perioperative clinical findings and short-term outcomes were analyzed. There were 20 men and 17 women with a mean age of 64.4 ± 13.5 years and a body mass index of 26.8 ± 5.7 kg/m. The mean operative time and estimated blood loss were 289.8 ± 85.3 min and 77.4 ± 70.5 ml, respectively. Conversion to laparoscopy occurred in one patient (2.7%). All the surgical margins were clear and the mesocolic plane surgery was achieved in 27 (72.9%) of the cases. The mean number of harvested lymph nodes was 41.8 ± 11.9 (median, 40; range 22-65). The mean length of hospital stay was 6.6 ± 3.7 days. The intraoperative and postoperative complication rates were 5.4 and 21.6%, respectively. We believe that use of robot for right-sided CME is feasible and appears to provide remarkably a high number of harvested lymph nodes with good specimen quality.
完整结肠系膜切除术（CME）的复杂性和手术风险似乎是将该手术广泛应用于右半结肠癌治疗的重要障碍。机器人系统的发展提高了微创手术的质量和效果。本研究旨在评估机器人右半结肠系膜切除术的可行性，并介绍我们的初步经验。回顾性分析了 2015 年 2 月至 2017 年 11 月期间 37 例行完全机器人右半结肠系膜切除术的患者。所有手术均采用 CME 与腔内吻合术的关键原则和无接触技术进行。分析了围手术期临床发现和短期结果的数据。20 例男性和 17 例女性，平均年龄 64.4±13.5 岁，体重指数 26.8±5.7kg/m。平均手术时间和估计出血量分别为 289.8±85.3min 和 77.4±70.5ml。1 例（2.7%）患者转为腹腔镜手术。所有手术切缘均清晰，27 例（72.9%）达到结肠系膜平面手术。平均采集淋巴结数为 41.8±11.9（中位数 40；范围 22-65）。平均住院时间为 6.6±3.7 天。术中并发症和术后并发症发生率分别为 5.4%和 21.6%。我们认为，机器人在右半结肠系膜切除术方面是可行的，并且似乎可以提供显著数量的高质量淋巴结。
