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完全机器人右半结肠切除术与机器人辅助右半结肠切除术的倾向评分匹配研究。

A propensity score matching study of totally robotic right hemicolectomy versus robot-assisted right hemicolectomy.

机构信息

First Afflicted Hospital of Xi'an Jiaotong University, Xi'an, 710000, Shanxi, China.

Department of Gastrointestinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.

出版信息

J Robot Surg. 2023 Jun;17(3):905-914. doi: 10.1007/s11701-022-01472-z. Epub 2022 Nov 6.

Abstract

To compare and analyze the differences in safety, feasibility and short-term efficacy between robot-assisted right hemicolectomy (RARH) and totally robotic right hemicolectomy (TRRH). We collected the information of 184 patients who underwent right hemicolectomy in the Second Xiangya Hospital of Central South University from July 2016 to December 2021. We matched 148 patients (74 with robot-assisted right hemicolectomy and 74 with totally robotic right hemicolectomy) to conduct a retrospective analysis of their clinical outcomes. The incision lengths were 5.14 ± 0.60 cm in the RARH group and 4.74 ± 0.55 cm in the TRRH (p < 0.001). The blood losses were 86.28 ± 52.57 mL in the RARH group and 69.19 ± 44.78 mL in the TRRH (p = 0.035). The operative times were 197.50 min (171.25-242.25) in the RARH group and 160.00 min (145.00-188.75) in the TRRH (p < 0.001). The postoperative hospital stays were 11.18 ± 4.32 days in the RARH group and 9.53 ± 4.42 days in the TRRH (p = 0.023). The NRS pain scores were 3.05 ± 0.23 in the RARH group and 2.96 ± 0.26 in the TRRH (p = 0.019). The abdominal drainage extraction times were 7.54 ± 1.44 days in the RARH group and 7.00 ± 1.25 days in the TRRH (p = 0.016). Postoperative complications in the RARH group are fewer than TRRH (p = 0.033). TRRH is safe and feasible. Compared with RARHs, the TRRHs resulted in shorter incision lengths, operative times, intraoperative blood losses, postoperative hospital stays, first flatus times, first liquid diet times, and drainage tube removal times, and they improved NRS pain scores and postoperative complication frequencies.

摘要

比较并分析机器人辅助右半结肠切除术(RARH)和全机器人右半结肠切除术(TRRH)在安全性、可行性和短期疗效方面的差异。我们收集了 2016 年 7 月至 2021 年 12 月期间在中南大学湘雅二医院接受右半结肠切除术的 184 名患者的信息。我们匹配了 148 名患者(74 名接受机器人辅助右半结肠切除术,74 名接受全机器人右半结肠切除术)进行回顾性分析他们的临床结果。RARH 组的切口长度为 5.14±0.60cm,TRRH 组为 4.74±0.55cm(p<0.001)。RARH 组的失血量为 86.28±52.57ml,TRRH 组为 69.19±44.78ml(p=0.035)。RARH 组的手术时间为 197.50min(171.25-242.25),TRRH 组为 160.00min(145.00-188.75)(p<0.001)。RARH 组的术后住院时间为 11.18±4.32 天,TRRH 组为 9.53±4.42 天(p=0.023)。RARH 组的 NRS 疼痛评分(3.05±0.23)低于 TRRH 组(2.96±0.26)(p=0.019)。RARH 组的腹部引流管拔除时间为 7.54±1.44 天,TRRH 组为 7.00±1.25 天(p=0.016)。RARH 组的术后并发症少于 TRRH 组(p=0.033)。TRRH 是安全可行的。与 RARH 相比,TRRH 具有切口长度更短、手术时间更短、术中失血量更少、术后住院时间更短、首次排气时间更早、首次进液时间更早、引流管拔除时间更早、NRS 疼痛评分更高、术后并发症发生率更低的优势。

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