学习曲线对肥胖直肠癌患者机器人手术结局的影响。

Impact of the learning curve on the outcomes of robotic surgery in obese patients with rectal cancer.

作者信息

Izukawa Shota, Numata Masakatsu, Fukuda Toshiyuki, Harada Tatsunosuke, Atsumi Yosuke, Kazama Keisuke, Sawazaki Sho, Suzuki Shinsuke, Godai Teni, Higuchi Akio, Tamagawa Hiroshi, Suwa Yusuke, Watanabe Jun, Sato Tsutomu, Saito Aya

机构信息

Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57, Urafune-Cho, Minami-Ku, Yokohama-City, Kanagawa, 232-0024, Japan.

Department of Surgery, Yokohama City University, 3-9, Fukuura, Kanazawa-Ku, Yokohama-City, Kanagawa, 236-0004, Japan.

出版信息

Surg Today. 2025 Sep 2. doi: 10.1007/s00595-025-03113-y.

DOI:10.1007/s00595-025-03113-y

PMID:40892105

Abstract

PURPOSE

One of the challenges in performing surgery on obese patients with rectal cancer is the prolonged operation time. This study investigates whether or not this issue can be overcome through the surgeon's learning curve as they become proficient in robotic surgery.

METHODS

A retrospective review of 396 consecutive robotic procedures. The cases were divided into a learning phase (LP) group (first 20 cases) and a stabilized phase (SP) group (from case 21 onward). Patients were divided into obese (BMI ≥ 25 kg/m) and non-obese groups using 1:1 propensity score matching. This resulted in 130 and 72 patients in the LP and SP groups, respectively. The primary endpoint of this study was operation time.

RESULTS

In the LP group, obese patients had significantly longer operative times (329 min vs. 289 min) and greater blood loss (10 g [0-50] vs. 10 g [0-12]) than non-obese patients. In the SP group, the perioperative outcomes, including operation time, were similar between the two patient groups.

CONCLUSION

This study suggests that during the early phase of the learning curve, operation time may be prolonged in obese patients. However, once the learning curve stabilizes, the issue of prolonged operative time can be overcome.

摘要