Department of Experimental Medicine, University of Salento, Lecce, Italy.
Department of Medicine and Surgery, University of Parma, Parma, Italy.
Updates Surg. 2024 Nov;76(7):2515-2520. doi: 10.1007/s13304-024-02014-y. Epub 2024 Oct 5.
Minimally invasive surgery for the treatment of colon and rectal cancer has gained popularity due to its association with reduced postoperative pain, shorter hospital stays, and quicker recovery. The Da Vinci Single-Port (SP) System combines single-port laparoscopy with robotic assistance. This scoping review aims to evaluate the safety and short-term postoperative outcomes of utilizing the Da Vinci SP platform in colorectal cancer surgery. A scoping review was conducted adhering to the PRISMA-ScR guidelines. Data were collected from PubMed, Embase, and the Web of Science Library as of December 22, 2023. Studies were screened and selected based on predefined criteria, focusing on the application of the SP robotic system in colorectal procedures. Data extraction included demographics, surgical details, intraoperative and postoperative outcomes. A narrative summary of the results was provided due to the heterogeneity in study designs. From an initial 2312 articles, 22 studies were selected for analysis, encompassing 465 patients undergoing robotic SP colorectal surgeries. Of these, 384 (82.6%) had a cancer diagnosis. The median age was 65 years, with approximately 60% being male. The median operative time was 225 min, with docking times averaging 12-20 min. Conversion to multi-port laparoscopy occurred in 4.2% of cases, with no conversions to open surgery. Mean intraoperative blood loss ranged from 50 to 150 ml. The mean number of lymph nodes retrieved ranged from 15 to 28. A diverting ileostomy was constructed in 20.3% of patients. Median times to flatus and soft diet were 2.5 and 3 days, respectively, with hospital stays ranging from 3 to 11 days. Perioperative complications occurred in 15.1% of patients, including wound infections (5.1%), anastomotic leakage (3.7%), and postoperative ileus (2.8%). Negative margin status (R0 resection) was achieved in 95% of cases. The Da Vinci SP robotic platform demonstrates promising safety and effectiveness in colorectal cancer surgery. It achieves high rates of successful oncological resection, adequate lymph node retrieval, and minimal intraoperative blood loss. Postoperative outcomes indicate quicker recovery times and manageable complication rates. However, longer follow-up studies are necessary to fully assess recurrence rates and long-term survival benefits associated with this innovative surgical approach.
由于微创外科治疗结肠癌和直肠癌具有术后疼痛减轻、住院时间缩短和恢复更快的特点,因此越来越受到关注。达芬奇单端口 (SP) 系统将单端口腹腔镜与机器人辅助结合在一起。本 scoping 综述旨在评估在结直肠癌手术中使用达芬奇 SP 平台的安全性和短期术后结果。 scoping 综述按照 PRISMA-ScR 指南进行。数据来自于截至 2023 年 12 月 22 日的 PubMed、Embase 和 Web of Science 库。根据预设标准筛选和选择研究,重点是 SP 机器人系统在结直肠手术中的应用。数据提取包括人口统计学、手术细节、术中及术后结果。由于研究设计的异质性,提供了结果的叙述性总结。从最初的 2312 篇文章中,选择了 22 项研究进行分析,其中包括 465 例接受机器人 SP 结直肠手术的患者。其中,384 例(82.6%)为癌症诊断。中位年龄为 65 岁,约 60%为男性。中位手术时间为 225 分钟,对接时间平均为 12-20 分钟。有 4.2%的病例转为多孔腹腔镜手术,没有转为开放性手术。术中平均失血量从 50 到 150ml 不等。平均取出的淋巴结数量从 15 到 28 个不等。20.3%的患者行预防性回肠造口术。排气和软食的中位时间分别为 2.5 和 3 天,住院时间为 3 至 11 天。15.1%的患者发生围手术期并发症,包括伤口感染(5.1%)、吻合口漏(3.7%)和术后肠梗阻(2.8%)。95%的病例达到阴性切缘状态(R0 切除)。达芬奇 SP 机器人平台在结直肠癌手术中具有良好的安全性和有效性。它能达到较高的肿瘤切除成功率、足够的淋巴结检出率和最小的术中出血量。术后结果表明恢复时间更快,并发症发生率可控。然而,需要进行更长时间的随访研究,以充分评估这种创新手术方法的复发率和长期生存获益。