Visceral Surgery Department, Geneva University Hospital, Geneva, Switzerland.
Division of Colorectal Surgery, Department of Surgery, George Washington University Hospital, Washington, DC.
Int J Med Robot. 2020 Apr;16(2):e2073. doi: 10.1002/rcs.2073. Epub 2020 Feb 13.
Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.
A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.
One hundred twenty-five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± 107.8 min vs 318.9 ± 75.1 min, P = .001). RAPR patients were discharged home more frequently (91.18% vs 66.67%, P = .001), and experienced fewer parastomal hernias (3.71% vs 9.86%, P = .001).
RAPR is safe and feasible with appropriate oncologic outcomes. Totally robotic approach reduces operative time and may improve functional outcomes.
腹腔镜经腹会阴联合切除术（APR）治疗低位直肠癌技术要求高。机器人辅助可能会有所帮助，并且可以是混合式（HAPR）或完全机器人式（RAPR）。本研究描述了机器人 APR 的结果，并比较了这两种方法。
对接受 HAPR 或 RAPR 的直肠癌患者进行了多中心回顾性分析。收集了患者的人口统计学、外科医生的经验、肿瘤学结果以及术中术后结果。
共纳入 125 例患者，其中 HAPR 组 48 例，RAPR 组 77 例。患者的人口统计学和合并症相似。RAPR 组的手术时间缩短（266.9±107.8 min 比 318.9±75.1 min，P=.001）。RAPR 患者更频繁地出院回家（91.18%比 66.67%，P=.001），并且发生吻合口旁疝的情况更少（3.71%比 9.86%，P=.001）。
RAPR 安全可行，具有适当的肿瘤学结果。完全机器人方法可缩短手术时间，并可能改善功能结果。
