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机器人全结肠系膜切除术与传统机器人右半结肠切除术治疗右侧结肠癌:围手术期结局的对比研究。

Robotic complete mesocolic excision versus conventional robotic right colectomy for right-sided colon cancer: a comparative study of perioperative outcomes.

机构信息

Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.

Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Surg Endosc. 2022 Mar;36(3):2113-2120. doi: 10.1007/s00464-021-08498-8. Epub 2021 Apr 12.

Abstract

AIM

This study aims to compare the short-term outcomes of robotic complete mesocolic excision (RCME) versus conventional robotic right colectomy (RRC) for right-sided colon cancer.

METHODS

Consecutive patients who underwent robotic surgery for right-sided colon cancer in a public quaternary and a private tertiary healthcare centre between November 2018 and June 2020 were included. Clinical, perioperative and histopathological variables were collected and analysed.

RESULTS

Fifty-one patients were included; 25 (49%) of them had an RCME. The groups were evenly distributed in terms of demographic characteristics and tumour location. Operative time was similar between both groups, and no patients required conversion to open surgery. There were no differences in overall complications (16% in RCME vs. 26.9% in RRC; p = 0.499) or their profile between groups. There were no anastomotic leaks recorded, and the reoperation rates were similar (0% for RCME versus 3.8% for RRC; p = 1). In addition, the median length of hospital stay was similar in between the RCME and the RRC groups (4 [4-6] days versus 5 [3-8.5] days, respectively; p = 0.891). Whilst there were no differences in the TNM staging, the mean number of lymph nodes harvested with RCME was 37.7 (±12.9) compared to 21.8 (±7.5) with RCC (p < 0.001).

CONCLUSION

In our series, RCME was associated with a higher lymph node harvest and a similar morbidity profile compared to RCC. Further studies are required to validate these results and provide long-term oncologic outcomes.

摘要

目的

本研究旨在比较机器人全结肠系膜切除术(RCME)与传统机器人右半结肠切除术(RRC)治疗右侧结肠癌的短期疗效。

方法

纳入 2018 年 11 月至 2020 年 6 月在一家公立四级医院和一家私立三级医院接受机器人手术治疗右侧结肠癌的连续患者。收集并分析了临床、围手术期和组织病理学变量。

结果

共纳入 51 例患者;其中 25 例(49%)接受了 RCME。两组在人口统计学特征和肿瘤部位方面分布均匀。两组的手术时间相似,均无患者需要转为开放性手术。两组的总体并发症发生率(RCME 组为 16%,RRC 组为 26.9%;p=0.499)或其特征无差异。无吻合口漏发生,再次手术率相似(RCME 组为 0%,RRC 组为 3.8%;p=1)。此外,RCME 组和 RRC 组的中位住院时间相似(分别为 4[4-6]天和 5[3-8.5]天;p=0.891)。虽然两组的 TNM 分期无差异,但 RCME 组平均淋巴结清扫数为 37.7(±12.9)个,而 RRC 组为 21.8(±7.5)个(p<0.001)。

结论

在我们的系列研究中,RCME 与 RRC 相比,淋巴结清扫更多,且发病率特征相似。需要进一步的研究来验证这些结果,并提供长期的肿瘤学疗效。

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