Calini Giacomo, Cardelli Stefano, Alexa Ioana Diana, Andreotti Francesca, Giorgini Michele, Greco Nicola Maria, Agama Fiorella, Gori Alice, Cuicchi Dajana, Poggioli Gilberto, Rottoli Matteo
Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40139 Bologna, Italy.
Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, 40139 Bologna, Italy.
Cancers (Basel). 2025 Mar 30;17(7):1164. doi: 10.3390/cancers17071164.
: The aim of the study was to compare the perioperative and oncologic outcomes of patients who underwent surgery for colorectal cancer (CRC) performed using laparoscopy or using the Medtronic Hugo™ Robotic-Assisted Surgery (RAS) system. This is a retrospective comparative single-center study of consecutive minimally invasive surgeries for CRC performed by two colorectal surgeons with extensive laparoscopic experience at the beginning of their robotic expertise. Patients were not selected for the surgical approach, but waiting lists and operating room availability determined whether the patients were in the robotic group or the laparoscopic group. The primary outcome was to compare 30-day postoperative complications according to the Clavien-Dindo classification and the Complication Comprehensive Index (CCI). The secondary outcomes included operating times, conversion rates, intraoperative complications, length of hospital stays (LOS), readmission rates, and short-term oncologic outcomes, such as the R0 resection, the number of lymph nodes harvested, the total mesorectal excision (TME) quality, and the circumferential resection margin (CRM). Of the 109 patients, 52 underwent robotic and 57 laparoscopic CRC surgery. Patient demographic and clinical characteristics were similar in the two groups. There was no significant difference between the robotic and the laparoscopic groups regarding postoperative complications, the Clavien-Dindo classification, and the CCI. They also had similar operating times, conversion rates, intraoperative complications, LOSs, readmission rates, and short-term oncologic outcomes (the lymph nodes harvested, the R0 resection, TME quality, and CRM status). This study reports the largest cohort of CRC surgery performed using the Medtronic Hugo™ RAS system and is the first comparative study with laparoscopy. The perioperative and oncologic outcomes were similar, demonstrating that the Medtronic Hugo™ RAS system is safe and feasible for CRC as compared to laparoscopic surgery, even at the beginning of the robotic experience.
本研究的目的是比较采用腹腔镜手术或美敦力Hugo™机器人辅助手术（RAS）系统进行结直肠癌（CRC）手术患者的围手术期和肿瘤学结局。这是一项回顾性比较单中心研究，纳入了由两位在机器人手术技术起步阶段就有丰富腹腔镜经验的结直肠外科医生连续进行的微创CRC手术。患者并非根据手术方式进行选择，而是等待名单和手术室可用性决定了患者是进入机器人手术组还是腹腔镜手术组。主要结局是根据Clavien-Dindo分类和并发症综合指数（CCI）比较术后30天并发症。次要结局包括手术时间、中转率、术中并发症、住院时间（LOS）、再入院率以及短期肿瘤学结局，如R0切除、淋巴结清扫数量、直肠系膜全切除（TME）质量和环周切缘（CRM）。109例患者中，52例行机器人辅助CRC手术，57例行腹腔镜CRC手术。两组患者的人口统计学和临床特征相似。机器人手术组和腹腔镜手术组在术后并发症、Clavien-Dindo分类和CCI方面无显著差异。他们在手术时间、中转率、术中并发症、住院时间、再入院率以及短期肿瘤学结局（淋巴结清扫、R0切除、TME质量和CRM状态）方面也相似。本研究报告了使用美敦力Hugo™ RAS系统进行CRC手术的最大队列，并且是与腹腔镜手术的首个比较研究。围手术期和肿瘤学结局相似，表明与腹腔镜手术相比，即使在机器人手术经验起步阶段，美敦力Hugo™ RAS系统用于CRC手术也是安全可行的。
