机器人辅助结肠癌手术：一项回顾性倾向匹配研究表明，与腹腔镜手术相比，恢复更快且疼痛更少。

Robotic-Assisted Colon Cancer Surgery: Faster Recovery and Less Pain Compared to Laparoscopy in a Retrospective Propensity-Matched Study.

作者信息

Lin Chun-Yu, Liu Yi-Chun, Chen Chou-Chen, Chen Ming-Cheng, Chiu Teng-Yi, Huang Yi-Lin, Chiang Shih-Wei, Lin Chang-Lin, Chen Ying-Jing, Lin Chen-Yan, Chiang Feng-Fan

机构信息

Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112211, Taiwan.

Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

出版信息

Cancers (Basel). 2025 Jan 13;17(2):243. doi: 10.3390/cancers17020243.

DOI:10.3390/cancers17020243

PMID:39858025

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11764117/

Abstract

: Colorectal cancer (CRC) is the third most common cancer worldwide, with colon cancer accounting for approximately 60% of all CRC cases. Surgery remains the primary and most effective treatment. Robotic-assisted surgery (RAS) has emerged as a promising approach for colon cancer resection. This retrospective study compares RAS and laparoscopic-assisted surgery (LSS) for stage I-III colon cancer resections at a single medical center in East Asia. : Between 1 January 2018, and 29 February 2024, patients undergoing colectomy were classified into right-side and left-side colectomies. Propensity score matching was conducted based on age group, gender, ASA score, and BMI to ensure comparability between groups. After matching, there were 50 RAS and 200 LSS cases for right colectomy (RC), and 129 RAS and 258 LSS cases for left colectomy (LC). Perioperative outcomes were compared between the two surgical approaches. The primary outcomes were recovery milestones, while secondary outcomes included complications and postoperative pain scores. : RAS demonstrated faster recovery milestones compared to LSS (hospital stay: 6.5 vs. 10.2 days, = 0.005 for RC; 5.5 vs. 8.2 days, < 0.001 for LC). RAS also resulted in lower rates of ileus (14% vs. 26%, = 0.064 for RC; 6.2% vs. 15.9%, = 0.007 for LC) and higher lymph node yields (31.4 vs. 26.8, = 0.028 for RC; 25.8 vs. 23.9, = 0.066 for LC). Major complication rates showed no significant difference between RAS and LSS (4.0% vs. 7.0%, = 0.746 for RC; 4.7% vs. 3.1%, = 0.563 for LC). Patients in the RAS group experienced earlier diuretic phases and reported significantly lower postoperative pain scores (3.0 vs. 4.1, = 0.011 for RC; 2.9 vs. 4.1, < 0.001 for LC). : Robotic-assisted surgery is associated with faster recovery, lower rates of ileus (LC), higher lymph node yield (RC) and reduced postoperative pain compared to laparoscopic-assisted surgery for colon cancer resection.

摘要

结直肠癌（CRC）是全球第三大常见癌症，其中结肠癌约占所有CRC病例的60%。手术仍然是主要且最有效的治疗方法。机器人辅助手术（RAS）已成为结肠癌切除的一种有前景的方法。这项回顾性研究比较了东亚一家单一医疗中心I - III期结肠癌切除的RAS和腹腔镜辅助手术（LSS）。：在2018年1月1日至2024年2月29日期间，接受结肠切除术的患者被分为右侧和左侧结肠切除术。根据年龄组、性别、美国麻醉医师协会（ASA）评分和体重指数（BMI）进行倾向得分匹配，以确保组间的可比性。匹配后，右侧结肠切除术（RC）有50例RAS和200例LSS病例，左侧结肠切除术（LC）有129例RAS和258例LSS病例。比较了两种手术方法的围手术期结果。主要结果是恢复里程碑，次要结果包括并发症和术后疼痛评分。：与LSS相比，RAS显示出更快的恢复里程碑（住院时间：RC为6.5天对10.2天，P = 0.005；LC为5.5天对8.2天，P < 0.001）。RAS还导致肠梗阻发生率较低（RC为14%对26%，P = 0.064；LC为6.2%对15.9%，P = 0.007）和更高的淋巴结收获量（RC为31.4对26.8，P = 0.028；LC为25.8对23.9，P = 0.066）。RAS和LSS之间的主要并发症发生率无显著差异（RC为4.0%对7.0%，P = 0.746；LC为4.7%对3.1%，P = 0.563）。RAS组患者利尿期更早且术后疼痛评分显著更低（RC为3.0对4.1，P = 0.011；LC为2.9对4.1，P < 0.001）。：与腹腔镜辅助手术相比，机器人辅助手术用于结肠癌切除与更快恢复、更低的肠梗阻发生率（LC）、更高的淋巴结收获量（RC）以及减轻术后疼痛相关。