S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer

被引:156
作者
Park, Jun Seok [1 ]
Choi, Gyu-Seog [1 ]
Lim, Kyoung Hoon [1 ]
Jang, You Seok [1 ]
Jun, Soo Han [1 ]
机构
[1] Kyungpook Natl Univ, Dept Surg, Kyungpook Natl Univ Hosp, Sch Med, Taegu 700721, South Korea
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2011年 / 25卷 / 01期
关键词
Robotic surgery; Short-term outcome; Rectal cancer; TOTAL MESORECTAL EXCISION; MRC CLASICC TRIAL; RESECTION; CARCINOMA; COLON; ANASTOMOSIS; OUTCOMES;
D O I
10.1007/s00464-010-1166-z
中图分类号
R61 [外科手术学];
学科分类号
摘要
In recent years, robot-assisted surgery using the da Vinci System(A (R)) has been proposed as an alternative to traditional open or laparoscopic procedures. The aim of this study was to compare the short-term outcomes for open, laparoscopic, and robot-assisted rectal resection for cancer. Two hundred sixty-three patients with rectal cancer who underwent curative resection between 2007 and 2009 were included. Patients were classified into an open surgery group (OS, n = 88), a laparoscopic surgery group (LAP, n = 123), and a robot-assisted group (RAP, n = 52). Data analyzed include operating time, length of recovery, methods of specimen extraction, quality of total mesorectal excision, and morbidity. The mean operating time was 233.8 +/- A 59.2 min for the OS group, 158.1 +/- A 49.2 min for the LAP group, and 232.6 +/- A 52.4 min for the RAP group (p < 0.001). Patients from the LAP and RAP groups recovered significantly faster than did those from the OS group (p < 0.05). The proportion of operations performed through a natural orifice (intracorporeal anastomosis with transanal or transvaginal retrieval of specimens) was significantly higher in the RAP group (p < 0.001). The specimen quality-with a distal resection margin, harvested lymph nodes, and circumferential margin-did not differ among the three groups. The overall complication rates were 20.5, 12.2, and 19.2% in the OS, LAP, and RAP groups, respectively (p = 0.229). RAP and LAP reproduce the equivalent short-term results of standard OS while providing the advantages of minimal access. For the experienced laparoscopic colorectal oncologist, use of the da Vinci robot resulted in no significant short-term clinical benefit over the conventional laparoscopic approach.
引用
收藏
页码:240 / 248
页数:9
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