Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland.
Robotic Assisted Surgery Programme, University Hospital Limerick, Limerick, Ireland.
J Robot Surg. 2021 Jun;15(3):389-396. doi: 10.1007/s11701-020-01116-0. Epub 2020 Jul 8.
Robotic colorectal surgery is gaining popularity. The objective of this study was to compare clinical and cancer outcomes in propensity-score matched cohorts (PSM-1:1) undergoing colorectal cancer (CRC) surgery performed using laparoscopic or robotic surgery in a single institution. A PSM cohort comparison was performed in a tertiary referral cancer and National accredited rectal cancer surgery centre. Patients with CRC undergoing laparoscopic or robotic resection with curative intent from 2016 to 2019 (inclusive) were assessed for inclusion. Matched cohorts were selected using a 1:1 ratio. Statistical analysis was performed using SPSS, version 22. 128 patients were analysed [laparoscopic (n = 64); robotic (n = 64)]. Median age was 64 years (29-84 years). 55% (n = 70) of patients were male, 45% female (n = 58). SSI rates were slightly lower in the robotic group [10.9% (n = 7) v 12.5% (n = 8) p = 0.40]. Anastomotic leak rates were equal in both groups [5.4% (n = 3)]. All but one patient received an R0 resection in each group, median LNY was 14 in the robotic group and 12 in the laparoscopic group (p = 0.004) and no difference in disease recurrence (p = 0.465) or survival (p = 0.886) was observed. Structured introduction of a robotic colorectal programme over a 3-year period has resulted in equivalent outcomes with an established laparoscopic programme for CRC.
机器人结直肠手术越来越受欢迎。本研究的目的是比较在单一机构中使用腹腔镜或机器人手术对结直肠癌(CRC)进行手术的倾向评分匹配队列(PSM-1:1)的临床和癌症结局。在一家三级转诊癌症和国家认可的直肠癌症手术中心进行了 PSM 队列比较。评估了 2016 年至 2019 年(包括)期间接受腹腔镜或机器人根治性切除术的 CRC 患者是否符合纳入标准。使用 1:1 的比例选择匹配队列。使用 SPSS 版本 22.1 进行统计分析。分析了 128 名患者[腹腔镜(n=64);机器人(n=64)]。中位年龄为 64 岁(29-84 岁)。55%(n=70)的患者为男性,45%为女性(n=58)。机器人组的 SSI 发生率略低[10.9%(n=7)比 12.5%(n=8),p=0.40]。两组吻合口漏发生率相等[5.4%(n=3)]。每组除一名患者外,其余患者均接受 R0 切除术,机器人组中位淋巴结清扫数为 14,腹腔镜组为 12(p=0.004),疾病复发(p=0.465)或生存(p=0.886)无差异。在 3 年期间引入机器人结直肠计划的结构已导致与 CRC 的既定腹腔镜计划相当的结果。