Esen Eren, Aytac Erman, Ağcaoğlu Orhan, Zenger Serkan, Balik Emre, Baca Bilgi, Hamzaoğlu İsmail, Karahasanoğlu Tayfun, Buğra Dursun
Department of General Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University.
Department of General Surgery, School of Medicine, Koç University, Istanbul, Turkey.
Surg Laparosc Endosc Percutan Tech. 2018 Aug;28(4):245-249. doi: 10.1097/SLE.0000000000000552.
In this study, perioperative and short-term postoperative results of totally robotic versus totally laparoscopic rectal resections for cancer were investigated in a comparative manner by considering risk factors including obesity, male sex, and neoadjuvant treatment. In addition to overall comparison, the impact of sex, obesity (body mass index ≥30 kg/m), and neoadjuvant treatment was assessed in patients who had a total mesorectal excision (TME). Operative time was longer in the robotic group (P<0.001). In obese patients who underwent TME, the mean length of hospital stay was shorter (7±2 vs. 9±4 d, P=0.01), and the mean number of retrieved lymph nodes was higher (30±19 vs. 23±10, P=0.02) in the robotic group. Totally robotic and totally laparoscopic surgery appears to be providing similar outcomes in patients undergoing rectal resections for cancer. Selective use of a robot may have a role for improving postoperative outcomes in some challenging cases including obese patients undergoing TME.
在本研究中，通过考虑肥胖、男性性别和新辅助治疗等风险因素，以对比的方式研究了全机器人手术与全腹腔镜直肠癌切除术的围手术期及术后短期结果。除了总体比较外，还评估了性别、肥胖（体重指数≥30 kg/m²）和新辅助治疗对接受全直肠系膜切除术（TME）患者的影响。机器人手术组的手术时间更长（P<0.001）。在接受TME的肥胖患者中，机器人手术组的平均住院时间更短（7±2天 vs. 9±4天，P=0.01），平均获取淋巴结数量更多（30±19个 vs. 23±10个，P=0.02）。全机器人手术和全腹腔镜手术在接受直肠癌切除术的患者中似乎提供了相似的结果。在一些具有挑战性的病例中，包括接受TME的肥胖患者，选择性使用机器人可能对改善术后结果具有作用。
