医学
围手术期
外科
腹腔镜手术
机械人手术
失血
结直肠癌
体质指数
吻合
腹腔镜检查
结直肠外科
腹部外科
癌症
内科学
作者
Jamil Ahmed,Han Cao,Sofoklis Panteleimonitis,Jim Khan,Amjad Parvaiz
摘要
Abstract Aim Laparoscopic rectal surgery is associated with a steep learning curve and high conversion rate despite progress in equipment design and consistent practice. The robotic system has shown an advantage over the laparoscopic approach due to stable three‐dimensional views, improved dexterity and better ergonomics. These factors make the robotic approach more favourable for rectal surgery. The aim of this study was to compare the perioperative outcomes of laparoscopic and robotic rectal cancer surgery in high‐risk patients. Method A prospectively collected dataset for high‐risk patients who underwent rectal cancer surgery between May 2013 and November 2015 was analysed. Patients with any of the following characteristics were defined as high risk: a body mass index ≥30, male gender, preoperative chemoradiotherapy, tumour <8 cm from the anal verge and previous abdominal surgery. Results In total, 184 high‐risk patients were identified: 99 in the robotic group and 85 in the laparoscopic group. Robotic surgery was associated with a significantly higher sphincter preservation rate (86% vs 74%, P = 0.045), shorter operative time (240 vs 270 min, P = 0.013) and hospital stay (7 vs 9 days, P = 0.001), less blood loss (10 vs 100 ml, P < 0.001) and a smaller conversion rate to open surgery (0% vs 5%, P = 0.043) compared with the laparoscopic technique. Reoperation, anastomotic leak rate, 30‐day mortality and oncological outcomes were comparable between the two techniques. Conclusion Robotic surgery in high‐risk patients is associated with higher sphincter preservation, reduced blood loss, smaller conversion rates, and shorter operating time and hospital stay. However, further studies are required to evaluate this notion.
科研通智能强力驱动
Strongly Powered by AbleSci AI