Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Number 291 Zhongzheng Road, Zhonghe District, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Division of Colorectal Surgery, Department of Surgery, WanFang Hospital, Taipei Medical University, No.111 Sec. 3 Xinglong Rd., Wenshan Dist., Taipei, Taiwan.
Asian J Surg. 2021 May;44(5):749-754. doi: 10.1016/j.asjsur.2020.12.017. Epub 2021 Jan 16.
Single incision laparoscopic colectomy (SILC) and single incision robotic colectomy (SIRC) are both advanced minimally invasive operative techniques. However, studies comparing these two surgical methods have not been published. The purpose of this study is to compare and evaluate the short-term outcomes of SIRC with those of SILC.
A total of 21 consecutive patients underwent SIRC and 136 consecutive patients underwent SILC in separate institutes between January 2013 and December 2019. We used retrospective cohort matching to analyze these patients.
Prior to matching, patients who underwent SIRC had a lower percentage of American Society of Anesthesiologists (ASA) grades III-IV (5% vs. 19%, P = 0.11) compared with patients who underwent SILC. The SIRC group revealed a higher proportion of sigmoid colon lesions and anterior resections than the SILC group (61% vs. 45%, P = 0.16). After 1:4 cohort matching, 21 patients were enrolled in the SIRC group and 84 patients were enrolled in the SILC group. No statistically significant difference in terms of operative time (SIRC: 185 ± 46 min, SILC: 208 ± 53 min; P = 0.51), estimated blood loss (SIRC: 12 ± 22 ml, SILC: 85 ± 234 ml; P = 0.12), and complications (SIRC: 4.7%, SIRC: 7.1%; P = 0.31) was observed between these groups. Length of postoperative hospital stay (SIRC: 8.3 ± 1.7 days, SILC: 9.3 ± 6.5; P = 0.10) and number of harvested lymph nodes (SIRC: 21.3 ± 10.3, SILC: 21.3 ± 9.5; P = 0.77) were also similar between the two groups. In subgroup analysis, numbers of harvested lymph node is less in SIRC than SILC (SIRC: 18.1 ± 4.7 vs. SILC: 18.9 ± 8.1, P = 0.04) in anterior resection.
SIRC and SILC are safe and feasible procedures with similar surgical and pathological outcomes for right- and left-side colectomy.
单孔腹腔镜结直肠切除术(SILC)和单孔机器人结直肠切除术(SIRC)均为先进的微创手术技术。然而,尚未有研究比较这两种手术方法。本研究旨在比较并评估 SIRC 与 SILC 的短期疗效。
2013 年 1 月至 2019 年 12 月,分别在两个不同的机构,共有 21 例患者接受了 SIRC 治疗,136 例患者接受了 SILC 治疗。我们使用回顾性队列匹配来分析这些患者。
在匹配之前,SIRC 组的美国麻醉医师协会(ASA)分级 III-IV 级患者比例(5%)低于 SILC 组(19%)(P=0.11)。SIRC 组中乙状结肠病变和前切除术的比例高于 SILC 组(61%比 45%)(P=0.16)。经 1:4 队列匹配后,SIRC 组纳入 21 例患者,SILC 组纳入 84 例患者。两组之间手术时间(SIRC:185±46 分钟,SILC:208±53 分钟;P=0.51)、估计失血量(SIRC:12±22 毫升,SILC:85±234 毫升;P=0.12)和并发症发生率(SIRC:4.7%,SILC:7.1%;P=0.31)均无统计学差异。两组术后住院时间(SIRC:8.3±1.7 天,SILC:9.3±6.5 天;P=0.10)和淋巴结清扫数目(SIRC:21.3±10.3,SILC:21.3±9.5;P=0.77)相似。亚组分析显示,前切除术患者中,SIRC 组淋巴结清扫数目少于 SILC 组(SIRC:18.1±4.7 个 vs. SILC:18.9±8.1 个,P=0.04)。
SIRC 和 SILC 是安全可行的手术方法,对于右半结肠和左半结肠切除术,手术和病理结果相似。