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机器人手术与腹腔镜手术治疗中低位直肠癌合并内脏肥胖的比较:倾向评分匹配分析。

Comparison of robotic versus laparoscopic surgery for visceral obesity in mid-low rectal cancer: a propensity-matched analysis.

机构信息

Clinical Teaching Hospital of Medical School, Northern Jiangsu People's Hospital, Nanjing University, Yangzhou, China.

Department of General Surgery, Taizhou Fourth People's Hospital, Taizhou, China.

出版信息

J Robot Surg. 2024 Apr 20;18(1):178. doi: 10.1007/s11701-024-01945-3.

Abstract

Obesity is becoming more and more common, and measuring visceral fat area (VFA) is a useful diagnostic technique for visceral obesity (VO). The purpose of this research is to compare the surgical results of robotic versus laparoscopic rectal surgery, with a focus on assessing the benefits of the latter method for treating both VO and mid-low rectal cancer. Patients receiving laparoscopic or robotic anterior rectal excision at Northern Jiangsu People's Hospital's general surgery department were included in the retrospective analysis. 242 people in all took part in the study; 121 cases were assigned to the robotic surgery (RS) group and another 121 cases to the laparoscopic surgery (LS) group. In comparison to LS, our results show that RS led to a shorter period for the recovery of bowel function (p = 0.03), a shorter hospital stay (p < 0.001), a smaller intraoperative blood loss (p < 0.001), and a shorter time until the commencement of oral intake (p = 0.041). However, there were no statistically significant differences between the two groups in terms of the indices of histopathologic specimens, the proportion of temporary loop ileostomy, and the incidence of early postoperative problems (p > 0.05). When patients with VO undergo surgery for rectal cancer, RS has the added benefit of accelerating patient recovery while producing results that are similar to LS in the near run.

摘要

肥胖症越来越普遍,测量内脏脂肪面积(VFA)是诊断内脏肥胖症(VO)的有用技术。本研究的目的是比较机器人与腹腔镜直肠手术的手术结果,重点评估后者治疗 VO 和中低位直肠癌的方法的益处。我们对苏北人民医院普通外科接受腹腔镜或机器人前侧直肠切除术的患者进行了回顾性分析。共有 242 人参与了这项研究,其中 121 例被分配到机器人手术(RS)组,另外 121 例被分配到腹腔镜手术(LS)组。与 LS 相比,我们的结果表明 RS 导致肠功能恢复时间更短(p=0.03)、住院时间更短(p<0.001)、术中出血量更少(p<0.001)、开始口服摄入的时间更短(p=0.041)。然而,两组在组织病理学标本指标、临时回肠造口术的比例和术后早期问题的发生率方面没有统计学差异(p>0.05)。当 VO 患者接受直肠癌手术时,RS 除了能加速患者恢复外,其近程效果与 LS 相似。

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