Department of General Surgery II, The First Medical Center of Chinese, PLA General Hospital, Fuxing Road, Haidian District, Beijing, China.
Department of Hepatobiliary Surgery II, The First Medical Center of Chinese, PLA General Hospital, Fuxing Road, Haidian District, Beijing, China.
Updates Surg. 2021 Jun;73(3):1049-1056. doi: 10.1007/s13304-020-00959-4. Epub 2021 Jan 4.
The objective of this study is to evaluate the perioperative and long-term outcomes of robot-assisted hemicolectomy (RAH) versus laparoscopy-assisted hemicolectomy (LAH) for left-sided colon cancers. Patients who underwent RAH and LAH from January 2012 to December 2018 were reviewed retrospectively. Patient characteristics and perioperative outcomes were compared between the two groups. Follow-up consultations were conducted to evaluate the long-term outcomes of these procedures. A total of 460 patients were included (RAH, n = 205; LAH, n = 255). There was no difference in patient characteristics between the two groups. Compared with the LAH group, the RAH group showed longer operative time (150.23 ± 43.77 min vs. 125.85 ± 38.67 min, p < 0.001) and higher surgery cost (6.33 ± 1.50 vs. 2.88 ± 0.72 thousand $, p < 0.001) and total hospital cost (14.97 ± 3.05 vs. 9.05 ± 2.31 thousand $, p < 0.001). No significant differences in tumor pathology, TNM staging, and perioperative outcomes were observed. There were no obvious differences in the 3-year and 5-year overall survival (OS) or 3-year and 5-year disease-free survival. Cox multivariate analyses showed that age, body mass index, and intravascular cancer embolus were independent risk factors for OS. Moreover, the robotic approach was not an independent risk factor for prognosis of left-sided colon cancers. RAH is an appropriate operation method for left-sided colon cancer, with perioperative and long-term outcomes comparable to those of laparoscopy. Meanwhile, RHA has longer operative time and higher cost.
本研究旨在评估机器人辅助左半结肠癌根治术（RAH）与腹腔镜辅助左半结肠癌根治术（LAH）的围手术期和长期疗效。回顾性分析 2012 年 1 月至 2018 年 12 月行 RAH 和 LAH 的患者。比较两组患者的一般资料和围手术期结果。通过随访评估这些手术的长期疗效。共纳入 460 例患者（RAH 组 205 例，LAH 组 255 例）。两组患者一般资料比较差异无统计学意义。与 LAH 组相比，RAH 组手术时间更长（150.23±43.77 min 比 125.85±38.67 min，p<0.001），手术费用更高（6.33±1.50 比 2.88±0.72 千美元，p<0.001），总住院费用更高（14.97±3.05 比 9.05±2.31 千美元，p<0.001）。两组肿瘤病理学、TNM 分期和围手术期结果差异无统计学意义。两组 3 年和 5 年总生存率（OS）和 3 年和 5 年无病生存率无明显差异。Cox 多因素分析显示，年龄、体质量指数和脉管内癌栓是 OS 的独立危险因素。此外，机器人手术不是左半结肠癌预后的独立危险因素。RAH 是治疗左半结肠癌的一种合适的手术方法，围手术期和长期疗效与腹腔镜相当。同时，RAH 手术时间更长，费用更高。
