Jeong Min Hye, Kim Hye Jin, Choi Gyu-Seog, Song Seung Ho, Park Jun Seok, Park Soo Yeun, Lee Sung Min, Na Dong Hee
Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Ann Surg Treat Res. 2023 Aug;105(2):99-106. doi: 10.4174/astr.2023.105.2.99. Epub 2023 Aug 1.
The da Vinci single-port (SP) system has been used in various surgical fields, including colorectal surgery. However, limited experience has been reported on its safety and feasibility. This study aims to evaluate the short-term outcomes of SP robotic surgery for the treatment of rectal cancer compared with multiport (MP) robotic surgery.
Rectal cancer patients who underwent curative resection in 2020 were reviewed. A total of 43 patients underwent robotic total mesorectal excision (TME), of which 26 (13 in each group, SP MP) were included in the case-matched cohort for analysis. Intraoperative and postoperative outcomes and pathological results were compared between the 2 groups.
Median tumor height was similar between the 2 groups (SP MP: 5.9 cm [range, 2.2-9.6 cm] 6.7 cm [range, 3.4-10.0 cm], P = 0.578). Preoperative chemoradiotherapy was equally performed (38.5%). The median estimated blood loss was less (20.0 mL [range, 5.0-20.0 mL] 30.0 mL [range, 20.0-30.0 mL], P = 0.020) and the median hospital stay was shorter (7 days [range, 6-8 days] 8 days [range, 7-9 days], P = 0.055) in the SP group. Postoperative complications did not differ (SP MP: 7.7% 23.1%, P = 0.587). One patient in the SP group and 3 in the MP group experienced anastomotic leakage.
SP robotic TME showed perioperative outcomes similar to MP robotic TME. The SP robotic system can be considered a surgical option for the treatment of rectal cancer. Further prospective randomized trials with larger cohorts are required.
达芬奇单孔（SP）系统已应用于包括结直肠手术在内的各种外科领域。然而，关于其安全性和可行性的报道经验有限。本研究旨在评估与多孔（MP）机器人手术相比，SP机器人手术治疗直肠癌的短期疗效。
回顾2020年接受根治性切除的直肠癌患者。共有43例患者接受了机器人全直肠系膜切除术（TME），其中26例（每组13例，SP组和MP组）纳入病例匹配队列进行分析。比较两组的术中、术后结果及病理结果。
两组肿瘤高度中位数相似（SP组与MP组：5.9 cm[范围2.2 - 9.6 cm]对6.7 cm[范围3.4 - 10.0 cm]，P = 0.578）。术前同步放化疗的实施情况相同（38.5%）。SP组的术中估计失血量中位数较少（20.0 mL[范围5.0 - 20.0 mL]对30.0 mL[范围20.0 - 30.0 mL]，P = 0.020），住院时间中位数较短（7天[范围6 - 8天]对8天[范围7 - 9天]，P = 0.055）。术后并发症无差异（SP组与MP组：7.7%对23.1%，P = 0.587）。SP组有1例患者，MP组有3例患者发生吻合口漏。
SP机器人TME显示出与MP机器人TME相似的围手术期结果。SP机器人系统可被视为治疗直肠癌的一种手术选择。需要进一步开展更大样本量的前瞻性随机试验。
