机器人辅助减少端口与腹腔镜手术治疗左侧结直肠癌的比较
Comparison of robotic reduced-port and laparoscopic approaches for left-sided colorectal cancer surgery.
作者信息
Wei Po-Li, Huang Yan-Jiun, Wang Weu, Huang Yu-Min
机构信息
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Cancer Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Translational Laboratory, Department of Medical Research, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, Taipei Medical University, Taipei, Taiwan.
Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
出版信息
Asian J Surg. 2023 Feb;46(2):698-704. doi: 10.1016/j.asjsur.2022.06.079. Epub 2022 Jun 29.
BACKGROUND/OBJECTIVE: The reduced-port approach can overcome the limitations of single-incision laparoscopic surgery while maintaining its advantages. Here, we compared the effects of robotic reduced-port surgery and conventional laparoscopic approaches for left-sided colorectal cancer.
METHODS
Between January 2015 and December 2016, the clinicopathological characteristics and treatment outcomes of 17 patients undergoing robotic reduced-port surgery and 49 patients undergoing laparoscopic surgery for left-sided colorectal cancer were compared.
RESULTS
The two groups were comparable in almost all outcome measures except for the distal resection margin, which was significantly longer in the laparoscopic group (P < 0.001). The between-group differences in reoperation, incisional hernia development, and overall and progression-free survival were nonsignificant; however, the total hospital cost was significantly higher in the robotic group than in the laparoscopic group (US$13779.6 ± US$3114.8 vs. US$8556.3 ± US$2056.7, P < 0.001).
CONCLUSION
Robotic reduced-port surgery for left-sided colorectal cancer is safe and effective but more expensive with no additional benefit compared with the conventional laparoscopic approach. This observation warrants further evaluation.
背景/目的：缩小切口入路可在保留单孔腹腔镜手术优势的同时克服其局限性。在此，我们比较了机器人辅助缩小切口手术与传统腹腔镜手术治疗左侧结直肠癌的效果。
方法
比较2015年1月至2016年12月期间17例行机器人辅助缩小切口手术的左侧结直肠癌患者与49例行腹腔镜手术患者的临床病理特征及治疗结果。
结果
除切缘外，两组在几乎所有结局指标上均具有可比性，腹腔镜组的远切缘明显更长（P<0.001）。两组在再次手术、切口疝发生、总生存及无进展生存方面的组间差异无统计学意义；然而，机器人组的总住院费用显著高于腹腔镜组（13779.6美元±3114.8美元 vs. 8556.3美元±2056.7美元，P<0.001）。
结论
机器人辅助缩小切口手术治疗左侧结直肠癌安全有效，但与传统腹腔镜手术相比费用更高且无额外获益。这一观察结果值得进一步评估。
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