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首页> 外文期刊>Surgical Endoscopy >Does robotic rectal cancer surgery improve the results of experienced laparoscopic surgeons? An observational single institution study comparing 168 robotic assisted with 184 laparoscopic rectal resections
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Does robotic rectal cancer surgery improve the results of experienced laparoscopic surgeons? An observational single institution study comparing 168 robotic assisted with 184 laparoscopic rectal resections

机译：机器人直肠癌手术是否有改善有经验的腹腔镜外科医生的结果？ 一个观察单机构研究比较168个机器人辅助184例腹腔镜直肠切除术

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BackgroundThe role of robotic assistance in colorectal cancer surgery has not been established yet. We compared the results of robotic assisted with those of laparoscopic rectal resections done by two surgeons experienced in laparoscopic as well as in robotic rectal cancer surgery.MethodsTwo surgeons who were already experienced laparoscopic colorectal surgeons in 2005 started robotic surgery with the daVinci SI system in 2012. All their rectal cancer resections between 2005 and 2015 were retrieved from a prospectively recorded colorectal database of routinely collected patient data. Multi-organ resections were excluded. Patient data, diagnostic data, data on preceding operations and neoadjuvant treatment, perioperative and operative data, logistic data, and short-term outcomes were gathered. Multivariable analyses (multiple linear and logistic regression) were used to assess differences in several outcomes between the two resection methods while adjusting for all potential confounders we could identify. Results are presented as adjusted mean differences for continuous outcome variables or as adjusted odds ratios (OR) for dichotomous outcome variables.ResultsThree hundred and fifty-two patients with rectal cancers were identified: 168 robotic and 184 conventional laparoscopic cases, 178 operated by surgeon A and 174 operated by surgeon B. Adjusted mean operation time was 215min in the robotic group which was 40min (95% CI 24-56; p0.0005) longer than the 175min in the laparoscopic group. Robotic treatment had significantly lesser numbers of conversions (OR 0.09 (0.03-0.32); p0.0005) and other complications (SSI and anastomic leakage excluded) (OR 0.32 (0.15-0.69); p=0.004), adjusted for potential confounders.ConclusionsOur study suggests that robotic surgery in the hands of experienced laparoscopic rectal cancer surgeons improves the conversion rate and complication rate drastically compared to conventional laparoscopic surgery, but operation time is longer.
机译：背景技术机器人援助在结直肠癌手术中的作用尚未建立。我们将机器人辅助的腹腔镜直肠切除结果进行了比较，这些外肠切除在腹腔镜和机器人直肠癌癌症外科治疗中。在2005年在2005年已经经历过腹腔镜结肠直肠外科医生的机器人外科医生开始于2012年与Davinci SI系统开始的机器人手术。从2005年至2015年之间的所有直肠癌切除从经常收集的患者数据的预期记录的结肠直肠数据库中检索。不包括多器官切除术。患者数据，诊断数据，上述操作中的数据以及新辅助治疗，围手术期和手术数据，物流数据以及短期结果。多变量分析（多线性和逻辑回归）用于评估两种切除方法之间的若干结果的差异，同时调整我们可以识别的所有潜在混淆。结果呈现为连续结果变量的调整平均差异或调整后的大量目标变量（或）用于二分法结果变量。鉴定了一百和五十二次直肠癌患者：168个机器人和184例常规腹腔镜病例，由外科医生操作178 174由外科医生B。调整后的平均手术时间为215mIn在腹腔镜组中的175min的40min（95％CI 24-56; P <0.0005）。机器人治疗具有显着较低的转化数（或0.09（0.03-0.32）; P <0.0005）和其他并发症（不包括吻合和吻合泄漏）（或0.32（0.15-0.69）; p = 0.004），调整潜在混淆。结论您的研究表明，与常规的腹腔镜手术相比，经验丰富的腹腔镜直肠癌外科医生手中的机器人手术提高了转化率和并发症率，但操作时间更长。

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