Department of Surgery, Kaiser Permanente Riverside Medical Center, Riverside, CA.
Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA.
Perm J. 2021 Dec 14;25:21.050. doi: 10.7812/TPP/21.050.
The treatment of rectal cancer is complex and involves specialized multidisciplinary care, although the tenet is still rooted in a high-quality total mesorectal excision. The robotic platform is one of many tools in the arsenal to assist dissection in the low pelvis. This article is a comprehensive review of the oncological outcome comparing robotic vs laparoscopic rectal cancer resection, with a particular focus on total mesorectal excision. There is no statistical difference in total mesorectal grade, circumferential margin, distal margin, and lymph node harvest. Survival data are less mature, but there is also no difference in disease-free or overall survival between the two techniques. Although additional randomized trials are still needed to validate these findings, both techniques are currently acceptable in the minimally invasive treatment of rectal cancer, and surgeon preference is paramount to safe and optimal resection.
直肠癌的治疗较为复杂,需要多学科的专业护理,但其治疗原则仍然是以高质量的全直肠系膜切除术为基础。机器人平台是辅助低位盆部解剖的众多工具之一。本文全面综述了机器人与腹腔镜直肠癌切除术的肿瘤学结果,特别关注全直肠系膜切除术。两种方法在全直肠系膜分级、环周切缘、远端切缘和淋巴结检出方面没有统计学差异。生存数据还不太成熟,但两种技术在无病生存率和总生存率方面也没有差异。尽管仍需要更多的随机试验来验证这些发现,但这两种技术目前都可被接受用于直肠癌的微创治疗,术者的偏好对于安全和优化的切除至关重要。