摘要
目的 对比分析机器人辅助与腹腔镜辅助左半结肠癌根治术的有效性与安全性.方法 本研究为回顾性研究,调取2021年3月至2024年3月于吉林大学第一医院普通外科中心胃结直肠外科接受左半结肠癌根治术的患者的临床资料进行分析.根据术式的不同,将接受腹腔镜辅助手术的患者归入腹腔镜辅助组,将接受机器人辅助手术的患者归入机器人辅助组.对比分析两组的基线资料、手术相关情况、术后病理资料和术后恢复情况.结果 共纳入149例患者的临床资料进行分析,其中腹腔镜辅助组109例,机器人辅助组40例.在基线资料方面,两组的年龄、身体质量指数、美国麻醉医师协会分级、肿瘤位置、术前肠道准备方式比较差异无统计学意义(P＞0.05);两组性别比例比较差异有统计学意义(P＜0.05),两组男性患者比例均更高.在手术相关情况方面,两组包括中转开腹率、术中出血量、总计手术时间在内的所有指标比较差异无统计学意义(P＞0.05).在术后病理资料方面,两组包括完整结肠系膜切除率、淋巴结检出数目、阳性淋巴结数目在内的所有指标比较差异无统计学意义(P＞0.05).在术后恢复情况方面,两组包括首次肛门排气时间、首次进食流质饮食时间、Clavien-Dindo Ⅱ级及以上的并发症发生率在内的所有指标比较差异无统计学意义(P＞0.05).机器人辅助组患者均完整切除结肠系膜、无中转开腹病例,机器人辅助手术并未明显延长总计手术时间.结论 机器人辅助左半结肠癌根治术与腹腔镜辅助左半结肠癌根治术的短期临床疗效相似.
Abstract
Objectives To compare and analyze the effectiveness and safety of robot-assisted and laparoscopic-assisted radi-cal resection for left-sided colon cancer.Methods This retrospective study analyzed the clinical data of patients who un-derwent radical resection for left-sided colon cancer at the Department of Gastrocolorectal Surgery,General Surgery Cen-ter,First Hospital of Jilin University from March 2021 to March 2024.Patients were divided into laparoscopic-assisted and robot-assisted groups based on the surgical approach.Baseline characteristics,surgery-related information,postopera-tive pathological data,and postoperative recovery were compared and analyzed between the two groups.Results A total of 149 patients were included in the analysis,with 109 in the laparoscopic-assisted group and 40 in the robot-assisted group.In terms of baseline characteristics,no statistically significant differences were observed between the two groups in age,body mass index,American Society of Anesthesiologists score,tumor location,or preoperative bowel preparation methods(P＞0.05).However,a statistically significant difference was noted in gender distribution(P＜0.05),with a higher proportion of male patients in both groups.There were no statistically significant differences in surgery-related in-formation between the two groups,including conversion to open surgery,intraoperative blood loss,or total surgical time(P＞0.05).No significant differences were found in postoperative pathological data between the two groups,including complete mesocolic excision rate,number of lymph nodes retrieved,or number of positive lymph nodes(P＞0.05).Simi-larly,no significant differences were observed in postoperative recovery,including time to first flatus,time to the first in-take of liquid diet,and incidence of Clavien-Dindo grade Ⅱ or higher complications(P＞0.05).All patients in the robot-assisted group achieved complete mesocolic excision without conversion to open surgery,and the robot-assisted surgery did not significantly prolong the total surgical time.Conclusion Robot-assisted and laparoscopic-assisted radical resection for left-sided colon cancer yield similar short-term clinical effectiveness.
维普
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