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首页> 外文期刊>Surgical Endoscopy >Robotic pelvic dissection as surgical treatment of complicated diverticulitis in elective settings: a comparative study with fully laparoscopic procedure
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Robotic pelvic dissection as surgical treatment of complicated diverticulitis in elective settings: a comparative study with fully laparoscopic procedure

机译：机器人盆腔剖检作为选择性环境中复杂憩室炎的手术治疗：完全腹腔镜手术的比较研究

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BackgroundRecently, minimally invasive treatment of complicated sigmoid diverticulitis is becoming a valid alternative to standard procedures. Robotic approach may be useful to allow more precise dissection in arduous pelvic dissection as in complicated diverticulitis. The aim of this study is to investigate effectiveness, potential benefits and short-term outcomes of robotic-assisted laparoscopic surgical resection, compared with fully laparoscopic resection in complicated diverticulitis.MethodsBetween January 2009 and December 2017, 156 consecutive patients with history of complicated diverticular disease were referred to our Department of General, Mininvasive and Robotic Surgery. All patients underwent elective colonic resections performed by the same colorectal surgeon and followed a perioperative ERAS program. Demographic and clinical features, surgical data, postoperative data, 30-day morbidity and mortality, VAS for surgeon's compliance were evaluated.ResultsOne hundred and fifty-six consecutive patients underwent elective colonic resection: 92 fully laparoscopic (FL) colorectal resections and 64 procedures with robotic hybrid approach (RHA). Conversion rate was none in the RHA group versus 6.5% in the FL group, because of poor vision due to bowel distension, inflammatory pseudotumor and peritoneal adhesions. No 30-day mortality was observed. Mean operative time was 167.554.4min (80-420) in the FL group and 172.5 +/- 55.64min (110-325) in the RHA group (p 0.079), mean intraoperative blood loss was 144.6 +/- 40.6ml (40-200) with the FL technique and 138.4 +/- 28.3ml (20-185) with the RHA (p 0.295). Mean hospital stay for FL was 5 +/- 4.1 days (range 3-45) and 5 +/- 2.7 days (range 3-20) for RHA (p 0.974). Overall postoperative morbidity rate was 21.6% in the FL group and 12.3% in the RHA (p 0.067). Major postoperative morbidity (Clavien-Dindo 3 and 4) represented 13% and 4.6%, respectively (p 0.091). VAS for surgeon's compliance revealed a better performance in the robotic arm (p 0.059).Conclusions This preliminary study highlights the potential benefits of robotic-assisted laparoscopy in colorectal resections for complicated diverticular disease in terms of surgical efficacy, postoperative morbidity and better surgeon's compliance.
机译：背景技术，对复杂的乙状腺憩室炎的微创治疗是标准程序的有效替代品。机器人方法可能是有用的，以允许在艰苦的骨盆分析中允许更精确的解剖如复杂的憩室炎。本研究的目的是调查机器人辅助腹腔镜手术切除的有效性，潜在的益处和短期结果，与完全腹腔镜切除在复杂的憩室炎中.2009年1月和2017年12月，156名患有复杂性疾病病史的连续患者被推荐给我们的一般，小型瓦，机器人手术。所有患者接受了相同的结肠外科医生的选修结肠切除术并遵循围手术期的时代计划。评估人口统计学和临床​​特征，手术数据，术后数据，30天发病率和死亡率，用于外科医生的遵守性的VAS.Resultsone百和五十六名连续患者接受选修结肠切除术：92个完全腹腔镜（FL）结肠直肠切除和64个程序机器人混合方法（RHA）。由于肠道扩张，炎症假荷和腹膜粘连，转化率为6.5％，而在FL组中没有6.5％。没有观察到过30天的死亡率。 FL组的平均手术时间为167.554.4min（80-420），172.5 +/- 55.64min（110-325）在RHA组（p 0.079），平均术中失血为144.6 +/- 40.6ml（40 -200）用FL技术和138.4 +/- 28.3ml（20-185），RHA（P 0.295）。 FL的平均医院住院是5 +/- 4.1天（范围3-45）和RHA的5 +/- 2.7天（3-20）（P 0.974）。 FL组的整体术后发病率为21.6％，红茶中12.3％（P <0.067）。主要的术后发病率（Clavien-Dindo 3和4）分别代表13％和4.6％（p 0.091）。外科医生遵守的VAS揭示了机器人臂上更好的性能（P 0.059）。结论这项初步研究突出了机器人辅助腹腔镜检查在外科疗效，术后发病率和更好的外科医生的遵守方面的结肠直肠切除术中的潜在益处。

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