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首页> 外文期刊>Surgical Endoscopy >Comparison of early experience of robotic and transanal total mesorectal excision using propensity score matching
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Comparison of early experience of robotic and transanal total mesorectal excision using propensity score matching

机译：使用倾向得分匹配比较机器人和躯体培养基外切除的早期经验

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BackgroundRobotic surgery and transanal minimally invasive surgery are the two recently developed techniques, which can overcome the difficult pelvic dissection in conventional laparoscopy. This study aimed to compare the early cases of robotic and transanal total mesorectal excision (taTME) using propensity score matching.MethodsThe first 40 cases of taTME and the first 80 sphincter-saving robotic total mesorectal resection for rectal cancer were selected from the prospectively collected database. Using propensity score matching, the outcomes of 40 matched cases of robotic TME were compared with the 40 cases of taTME.ResultsBefore matching, patients in the taTME group were significantly younger. The tumors were smaller but more distally located. Significantly more patients in the taTME group received preoperative chemoradiation. After matching, the two groups did not show any differences in gender, age, comorbidity, the level of tumors, and incidences of preoperative chemoradiation. The operating time was significantly shorter (254 vs. 170min, p<0.05) and the blood loss was less (50 vs. 150ml, p=0.002) in the taTME group. Conversion rate was 5% in both groups. There was no difference in the hospital stay, overall morbidity, the anastomotic leakage rate, and the urinary complication rate between the two groups. More patients in the taTME group did not require a separate abdominal incision. The distal margin, the number of lymph nodes examined, and the rate positive circumferential margin (0 vs. 5%, p=0.494) were also similar between the two groups.ConclusionsBoth taTME and robotic surgery can achieve favorable outcomes in the rectal cancer resection. Comparison of the early experience of the two procedures with propensity score matching showed the taTME was associated with a shorter operating time, less blood loss, and a higher rate of transanal extraction of the specimen. Further evaluation by randomized trials is warranted.
机译：Brosessionrobotic手术和常新侵袭性手术是最近开发的两种技术，这可以克服常规腹腔镜检查中困难的盆腔解剖。本研究旨在使用倾向得分匹配比较机器人和躯体总培素切除（TATME）的早期病例。从前瞻性的数据库中选择了前40例TATME和前80例括约肌节省的机器人总切除术。使用倾向得分匹配，将40例匹配案例的机器人TME的结果与TATME.ResultsBefore匹配的40例进行了比较，TATME组的患者显着下降。肿瘤较小但更远侧。 TATME组中患者显着更多地接受术前校长。在匹配后，两组未显示性别，年龄，合并症，肿瘤水平的任何差异，以及术前校长的发生率。操作时间明显缩短（254 vs.170min，P <0.05），并且在TATME组中损失较少（50 vs.150ml，p = 0.002）。两组转换率为5％。住院住宿，总体发病率，吻合液泄漏率没有差异，两组之间的尿复杂率。更多患者在TATME组中患者不需要单独的腹部切口。远端边缘，所检查的淋巴结数和速率正周缘（0与5％，p = 0.494）也是相似的两组。结论塔特姆和机器人手术可以在直肠癌切除中实现有利的结果。两种程序的早期经验的比较倾向得分匹配显示，TATME与较短的操作时间，较小的失血，较高速率的试样的较高速率相关。经受随机试验的进一步评估。

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