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机器人辅助腹腔镜手术治疗直肠癌的短期和长期疗效:单中心回顾性队列研究。

Short- and long-term outcomes of robotic-assisted laparoscopic surgery for rectal cancer: A single-center retrospective cohort study.

机构信息

Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

Department of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

出版信息

Asian J Endosc Surg. 2022 Oct;15(4):794-804. doi: 10.1111/ases.13095. Epub 2022 Jun 16.

Abstract

INTRODUCTION

Whether rectal cancer surgery by robotic-assisted laparoscopic surgery provides beneficial advantages remains controversial. Although favorable outcomes in terms of the safety and technical feasibility of robotic-assisted laparoscopic surgery have been demonstrated for rectal cancer, long-term oncological outcomes for robotic-assisted laparoscopic surgery have only been examined in a few studies. This retrospective study of subjects who underwent robotic-assisted laparoscopic surgery evaluated short- and long-term outcomes of consecutive rectal cancer patients.

METHODS

Between November 2016 and January 2020, we analyzed the records of 62 consecutive patients who underwent robotic-assisted laparoscopic surgery for rectal adenocarcinoma without distant metastasis to evaluate short- and long-term outcomes.

RESULTS

Tumors were located in the lower or mid-rectum (88.7%) in most patients. The median operative time was 357 min. No patient received transfusions, and the median blood loss was 10.5 ml. Open laparotomy was not required in any patient. A Clavien-Dindo classification of all grades was observed in 12 patients (19.4%). Positive radial margin was not observed in any patient. Duration of median follow-up was 40.5 mo, while 3-y overall survival and 3-y relapse-free survival rates were 96.8% and 85.0%, respectively. The local recurrence rate was 3.4%.

CONCLUSION

Favorable short- and long-term outcomes demonstrated robotic-assisted laparoscopic surgery was safe and technically feasible for rectal cancer.

摘要

介绍

机器人辅助腹腔镜手术治疗直肠癌是否具有有益优势仍存在争议。尽管已经证明机器人辅助腹腔镜手术在直肠癌的安全性和技术可行性方面具有优势,但机器人辅助腹腔镜手术的长期肿瘤学结果仅在少数研究中进行了检查。本项回顾性研究对接受机器人辅助腹腔镜手术的患者进行了评估,分析了连续直肠腺癌患者的短期和长期结果。

方法

在 2016 年 11 月至 2020 年 1 月期间,我们分析了 62 例连续接受机器人辅助腹腔镜手术治疗直肠腺癌且无远处转移的患者的记录,以评估短期和长期结果。

结果

大多数患者的肿瘤位于直肠下段或中段(88.7%)。中位手术时间为 357 分钟。没有患者需要输血,中位出血量为 10.5ml。没有患者需要进行开放性剖腹手术。12 例患者(19.4%)发生了所有等级的 Clavien-Dindo 分类。没有患者出现阳性切缘。中位随访时间为 40.5 个月,3 年总生存率和 3 年无复发生存率分别为 96.8%和 85.0%。局部复发率为 3.4%。

结论

机器人辅助腹腔镜手术治疗直肠癌具有良好的短期和长期结果,安全且技术上可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05e1/9796680/0377288b15b7/ASES-15-794-g001.jpg

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