Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Department of Biomedical and Clinical Sciences, Division of Surgery, Linköping University, Linköping, Sweden.
Scand J Urol. 2021 Feb;55(1):41-45. doi: 10.1080/21681805.2020.1843534. Epub 2020 Nov 10.
Whereas the literature has demonstrated an acceptable safety profile of stapled anastomoses when compared to the hand-sewn alternative in open surgery, the choice of intestinal anastomosis using sutures or staples remains inadequately investigated in robotic surgery. The purpose of this study was to compare the surgical outcomes of both anastomotic techniques in robotic-assisted radical cystectomy.
A retrospective analysis of patients with urinary bladder cancer undergoing cystectomy with urinary diversion and with ileo-ileal intestinal anastomosis at a single tertiary centre (2012-2018) was undertaken. The robotic operating time, hospital stay and GI complications were compared between the robotic-sewn (RS) and stapled anastomosis (SA) groups. The only difference between the groups was the anastomosis technique; the other technical steps during the operation were the same. Primary outcomes were GI complications; the secondary outcome was robotic operation time.
There were 155 patients, of which 112 (73%) were male. The median age was 71 years old. A surgical stapling device was used to create 66 (43%) separate anastomoses, while a robot-sewn method was employed in 89 (57%) anastomoses. There were no statistically significant differences in primary and secondary outcomes between RS and SA.
Compared to stapled anastomosis, a robot-sewn ileo-ileal anastomosis may serve as an alternative and cost-saving approach.
与开放式手术中的手工缝合相比，吻合器吻合具有可接受的安全性，然而，在机器人手术中，使用缝线或吻合器进行肠吻合的选择仍未得到充分研究。本研究的目的是比较机器人辅助根治性膀胱切除术两种吻合技术的手术结果。
对在单中心（2012-2018 年）接受膀胱切除术和回肠-回肠肠吻合术的膀胱癌患者进行回顾性分析。比较机器人缝合（RS）和吻合器吻合（SA）两组患者的机器人手术时间、住院时间和胃肠道并发症。两组唯一的区别是吻合技术；手术过程中的其他技术步骤相同。主要结局是胃肠道并发症；次要结局是机器人手术时间。
共有 155 例患者，其中 112 例（73%）为男性。中位年龄为 71 岁。66 例（43%）采用外科吻合器制造单独的吻合，89 例（57%）采用机器人缝合方法。RS 和 SA 两组在主要和次要结局方面无统计学差异。
与吻合器吻合相比，机器人缝合回肠-回肠吻合术可能是一种替代方法，且具有成本效益。
