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恶性肿瘤的结直肠切除术:一项比较传统徒手机器人辅助腹腔镜结肠切除术的试点研究。

Colorectal resections for malignancy: A pilot study comparing conventional freehand robot-assisted laparoscopic colectomy.

作者信息

Cawich Shamir O, Plummer Joseph Martin, Griffith Sahle, Naraynsingh Vijay

机构信息

Department of Surgery, University of the West Indies, St Augustine, Trinidad and Tobago.

Department of General Surgery and Consultant General and Colorectal Surgeon, Department of Surgery, University of the West Indies, Kingston, KIN7, Jamaica.

出版信息

World J Clin Cases. 2024 Jan 26;12(3):488-494. doi: 10.12998/wjcc.v12.i3.488.

Abstract

BACKGROUND

Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer, but we have experienced resistance to the introduction of the FreeHand robotic camera holder to augment laparoscopic colorectal surgery.

AIM

To compare the initial results between conventional and FreeHand robot-assisted laparoscopic colectomy in Trinidad and Tobago.

METHODS

This was a prospective study of outcomes from all laparoscopic colectomies performed for colorectal carcinoma from November 29, 2021 to May 30, 2022. The following data were recorded: Operating time, conversions, estimated blood loss, hospitalization, morbidity, surgical resection margins and number of nodes harvested. All data were entered into an excel database and the data were analyzed using SPSS ver 20.0.

RESULTS

There were 23 patients undergoing colectomies for malignant disease: 8 (35%) FreeHand-assisted and 15 (65%) conventional laparoscopic colectomies. There were no conversions. Operating time was significantly lower in patients undergoing robot-assisted laparoscopic colectomy (95.13 ± 9.22 105.67 ± 11.48 min; = 0.045). Otherwise, there was no difference in estimated blood loss, nodal harvest, hospitalization, morbidity or mortality.

CONCLUSION

The FreeHand robot for colectomies is safe, provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

摘要

背景

腹腔镜结肠切除术被广泛认为是一种治疗结直肠癌的安全手术,但我们在引入FreeHand机器人摄像头支架以增强腹腔镜结直肠手术方面遇到了阻力。

目的

比较特立尼达和多巴哥传统腹腔镜结肠切除术与FreeHand机器人辅助腹腔镜结肠切除术的初步结果。

方法

这是一项对2021年11月29日至2022年5月30日期间所有因结直肠癌进行的腹腔镜结肠切除术的结果进行的前瞻性研究。记录了以下数据:手术时间、中转率、估计失血量、住院时间、发病率、手术切缘和获取的淋巴结数量。所有数据都输入到一个Excel数据库中,并使用SPSS 20.0版本进行分析。

结果

有23例患者因恶性疾病接受结肠切除术:8例(35%)为FreeHand辅助手术,15例(65%)为传统腹腔镜结肠切除术。没有中转病例。接受机器人辅助腹腔镜结肠切除术的患者手术时间明显更短(95.13±9.22对105.67±11.48分钟;P = 0.045)。否则,在估计失血量、淋巴结获取、住院时间、发病率或死亡率方面没有差异。

结论

用于结肠切除术的FreeHand机器人是安全的,与传统腹腔镜手术相比具有一些优势,并且在资源匮乏的加勒比地区环境中不会影响肿瘤学标准。

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