Objectives To compare the clinical effects of robot-assisted total mesorectal excision(RoTME)and transanal total mesorectal excision(taTME)in the treatment of low rectal cancer.Methods A retrospective analysis was conducted on the clinical data of 58 patients with low rectal cancer admitted to the General Hospital of Northern Theater Com-mand of the Chinese People's Liberation Army from January 2021 to June 2023.Based on the surgical approach,pa-tients were divided into the RoTME group(n=27)and the taTME group(n=31).Oncologic indicators,safety indicators,and anal and urinary function indicators were compared between the two groups.Results The distance of the distal re-section margin was significantly closer in the taTME group compared to the RoTME group(P＜0.001).High-quality meso-rectal excision was achieved in 29 cases(93.5％)in the taTME group and all 27 cases in the RoTME group,with no sta-tistically significant difference(P=0.494).No significant differences were observed between the two groups in terms of maximum tumor diameter,number of lymph nodes dissected,and pathological tumor node metastasis stage(P＞0.05).All surgeries were completed without conversion to open surgery or intraoperative blood transfusion.Postoperative complica-tions occurred in 6 patients,with 4 Clavien-Dindo grade Ⅱ complications in the taTME group and 2 in the RoTME group,showing no statistically significant difference in complication rates(P＞0.05).Ten patients(37.0％)in the RoTME group underwent prophylactic end ileostomy.No significant differences were found in operative time,intraoperative blood loss,and hospital stay between the two groups(P＞0.05).The postoperative Wexner incontinence score,low anterior re-section syndrome(LARS)scores,and International Prostate Symptom Score(IPSS)in the RoTME group were higher than those in the taTME group,and the differences were statistically significant(P＜0.05).The score of the International Con-sultation on Incontinence Modular Questionnaire on Male/Female Lower Urinary Tract Symptoms Scale(ICIQ-MLUTS/FLUTS)for males in the RoTME group was higher than that in the taTME group,and the difference was statistically sig-nificant(P＜0.05).There was no statistically significant difference(P＞0.05)in the scores of the ICIQ Scale between the two groups of women after surgery.Conclusion Both RoTME and taTME are safe and effective surgical options for low rectal cancer.taTME provides a more precise determination of the distal resection margin and may better preserve male urinary function,but it has a greater impact on postoperative anal function.
关键词
直肠癌/机器人辅助全直肠系膜切除术/经肛全直肠系膜切除术
Key words
rectal cancer/robot-assisted total mesorectal excision/transanal total mesorectal excision
维普
万方数据