Suppr超能文献

使用新型腹腔镜关节器械Artisential行腹腔镜全结肠系膜切除术联合D3淋巴结清扫治疗右结肠癌的初步经验

Initial experience of laparoscopic complete mesocolic excision with D3 lymph node dissection for right colon cancer using Artisential, a new laparoscopic articulating instrument.

作者信息

Jin Hyeong Yong, Ibahim Abulfetouh M, Bae Jung Hoon, Lee Chul Seung, Han Seung Rim, Lee In Kyu, Lee Do Sang, Lee Yoon Suk

机构信息

Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.

Department of Surgery, Faculty of Medicine, Assiut University Hospital, Assiut University, Assiut, Egypt.

出版信息

J Minim Access Surg. 2022 Apr-Jun;18(2):235-240. doi: 10.4103/jmas.JMAS_88_21.

Abstract

BACKGROUND

Laparoscopic complete mesocolic excision (CME) with D3 lymph node dissection for the right colon is becoming popular, but still technically challenging. Several articulating laparoscopic instruments had been introduced to reduce technical difficulties; however, those were not practical. This study aimed to report the first clinical experience of using ArtiSential, a new laparoscopic articulating instrument in laparoscopic complete mesocolic with D3 lymph node dissection for right colon cancer.

PATIENTS AND METHODS

This was a retrospective, single-institution, consecutive case study. From October 2018 to March 2020, a total of 33 patients underwent laparoscopic right hemicolectomy using ArtiSential, a new articulating instrument. We compared the short-term outcomes of patients who underwent surgery using ArtiSential (AG) to the conventional instrument (CG).

RESULTS

In total, there were 33 cases in AG and 43 cases in CG. There were no significant differences in operation time (141.0 ± 22.5 vs. 156.0 ± 50.6 min, P = 0.09), mean estimated blood loss (46.8 ± 36.2 vs. 100.8 ± 300.6 ml, P = 0.31) and intra-operative and post-operative complications. However, the number of harvested lymph nodes was higher and the length of hospital stay was shorter in AG than in CG (32.6 ± 12.2 vs. 24.6 ± 7.4, P < 0.01 and 3.0 ± 1.2 vs. 4.1 ± 2.2 days, P = 0.01, respectively).

CONCLUSIONS

Laparoscopic CME with D3 lymph node dissection for right colon cancer using ArtiSential, the new articulating laparoscopic instrument is safe and technically feasible.

摘要

背景

腹腔镜下全结肠系膜切除术(CME)联合右半结肠D3淋巴结清扫术正逐渐普及,但在技术上仍具有挑战性。为降低技术难度,已引入多种可弯曲腹腔镜器械;然而,这些器械并不实用。本研究旨在报告首例使用新型腹腔镜可弯曲器械ArtiSential行腹腔镜下全结肠系膜切除联合右半结肠D3淋巴结清扫术治疗右半结肠癌的临床经验。

患者与方法

这是一项回顾性、单中心、连续病例研究。2018年10月至2020年3月,共有33例患者使用新型可弯曲器械ArtiSential接受了腹腔镜右半结肠切除术。我们将使用ArtiSential(AG组)手术的患者与使用传统器械(CG组)手术的患者的短期结局进行了比较。

结果

AG组共33例,CG组共43例。手术时间(141.0±22.5 vs. 156.0±50.6分钟,P = 0.09)、平均估计失血量(46.8±36.2 vs. 100.8±300.6毫升,P = 0.31)以及术中及术后并发症方面,两组间无显著差异。然而,AG组的淋巴结清扫数量更多,住院时间更短(分别为32.6±12.2 vs. 24.6±7.4,P < 0.01;3.0±1.2 vs. 4.1±2.2天,P = 0.01)。

结论

使用新型腹腔镜可弯曲器械ArtiSential行腹腔镜下右半结肠癌CME联合D3淋巴结清扫术是安全且技术可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b24a/8973474/d5d64ef85094/JMAS-18-235-g001.jpg

相似文献

3
An Optimal Approach for Laparoscopic D3 Lymphadenectomy Plus Complete Mesocolic Excision (D3+CME) for Right-Sided Colon Cancer.
Ann Surg Oncol. 2017 May;24(5):1312-1313. doi: 10.1245/s10434-016-5722-1. Epub 2016 Dec 19.
6
Laparoscopic complete mesocolic excision with radical lymph node dissection along the surgical trunk for right colon cancer.
Surg Endosc. 2015 Jan;29(1):34-40. doi: 10.1007/s00464-014-3650-3. Epub 2014 Jul 2.
8
[Short-term outcomes of complete mesocolic excision for right colon cancer].
Khirurgiia (Mosk). 2017(8):79-86. doi: 10.17116/hirurgia2017879-86.

引用本文的文献

1
Short-term outcomes and the learning curve for laparoscopic right hemicolectomy using the ArtiSential: a multicenter pooled analysis.
Surg Endosc. 2025 May;39(5):2931-2937. doi: 10.1007/s00464-025-11670-z. Epub 2025 Mar 20.
4
6
Utility of articulating instruments as an alternative to robotic devices in laparoscopic right hemicolectomy.
Int Cancer Conf J. 2024 Feb 6;13(2):78-82. doi: 10.1007/s13691-024-00654-w. eCollection 2024 Apr.

本文引用的文献

1
2
Laparoscopic extended right hemicolectomy with D3 lymph node dissection using a new articulating instrument.
Tech Coloproctol. 2021 Feb;25(2):235-237. doi: 10.1007/s10151-020-02345-z. Epub 2020 Sep 14.
4
A Novel Intuitively Controlled Articulating Instrument for Reoperative Foregut Surgery: A Case Report.
J Laparoendosc Adv Surg Tech A. 2017 Sep;27(9):983-986. doi: 10.1089/lap.2017.0107. Epub 2017 Jul 20.
6
Laparoscopic complete mesocolic excision: West meets East.
World J Gastroenterol. 2014 Oct 21;20(39):14301-7. doi: 10.3748/wjg.v20.i39.14301.
7
Robotic versus laparoscopic right colectomy: a meta-analysis.
World J Surg Oncol. 2014 Aug 28;12:274. doi: 10.1186/1477-7819-12-274.
9
Insufficient joint forces of first-generation articulating instruments for laparoendoscopic single-site surgery.
Surg Innov. 2013 Oct;20(5):466-70. doi: 10.1177/1553350612468961. Epub 2012 Dec 14.
10
Robot-assisted right colectomy with lymphadenectomy and intracorporeal anastomosis for colon cancer: technical considerations.
Surg Laparosc Endosc Percutan Tech. 2012 Oct;22(5):e271-6. doi: 10.1097/SLE.0b013e31826581bd.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验