Alkhamis Ahmed A, Soliman Diaa M, Alsadder Khaled A, Busalha Hashem M, Alrashed Ahmad S, Alshaban Bader H, Alsafran Salman K, Almazeedi Sulaiman M
Med Princ Pract. 2024 Apr 3;33(4):364-71. doi: 10.1159/000538635.
The robotic platform compared to laparoscopy has proven to have similar postoperative outcomes, however its adoption in the Middle East has been slow and there is limited data regarding outcomes with its use in small newly established robotic colorectal programs. Our aim was to report our experience and outcomes of robotic colorectal surgery performed by fellowship-trained robotic colorectal surgeons and compare them to larger, more experienced centers.
This is retrospective review of data collected between November 2021 and March 2023 from a tertiary health care referral center. The series included 51 patients who had elective or urgent robotic colorectal surgery. Patients who had emergency surgery were excluded. The outcomes were overall morbidity, serious morbidity, mortality, conversion to open, length of hospital stay, and quality of oncological specimen.
The overall morbidity was 31.4% (n = 16 patients). Only 9.8% (n = 5) had serious morbidity of which three required interventions under general anesthesia. The median length of hospital stay was 6 days (IQR = 4), and there was no mortality. Of 17 rectal cancer resections, 88% had complete mesorectal excision, 15 of them were R0 resections, median lymph node harvested was 14 (IQR = 7) and two cases were converted to open. All the colon cancer resections had R0 resection, median lymph nodes harvested was 21 (IQR = 4) and none were converted to open.
The implementation and integration of robotic colorectal surgery at a newly established center in a small country, when led by fellowship trained robotic colorectal surgeons, is safe and effective in terms of morbidity, mortality, conversion to open and specimen pathological quality.
与腹腔镜手术相比，机器人手术平台已被证明具有相似的术后效果，然而其在中东地区的应用进展缓慢，且关于其在小型新建机器人结直肠手术项目中的应用效果的数据有限。我们的目的是报告由接受过 fellowship 培训的机器人结直肠外科医生进行的机器人结直肠手术的经验和结果，并将其与更大、更有经验的中心进行比较。
这是一项对 2021 年 11 月至 2023 年 3 月期间从一家三级医疗保健转诊中心收集的数据的回顾性研究。该系列包括 51 例接受择期或急诊机器人结直肠手术的患者。排除接受急诊手术的患者。观察指标包括总体发病率、严重发病率、死亡率、转为开腹手术率、住院时间和肿瘤标本质量。
总体发病率为 31.4%（n = 16 例患者）。只有 9.8%（n = 5）有严重发病情况，其中 3 例需要在全身麻醉下进行干预。住院时间中位数为 6 天（四分位间距 = 4），且无死亡病例。在 17 例直肠癌切除术中，88% 进行了完整的直肠系膜切除，其中 15 例为 R0 切除，中位淋巴结清扫数为 14 个（四分位间距 = 7），2 例转为开腹手术。所有结肠癌切除术均为 R0 切除，中位淋巴结清扫数为 21 个（四分位间距 = 4），无一例转为开腹手术。
在一个小国的新建中心，由接受过 fellowship 培训的机器人结直肠外科医生主导实施机器人结直肠手术，在发病率、死亡率、转为开腹手术率和标本病理质量方面是安全有效的。
