Short-term Clinical Outcomes of Robotic-assisted Total Mesorectal Excision in Low-lying Rectal Cancer

在低位直腸癌使用達文西機械手臂輔助全直腸繫膜切除術之短期臨床成果

陳伯榕(Po-Jung Chen) ； 黃敬文(Ching-Wen Huang) ； 蔡祥麟(Hsiang-Lin Tsai) ； 葉永松(Yung-Sung Yeh) ； 蘇偉智(Wei-Chih Su) ； 張琮琨(Tsung-Kun Chang) ； 黃旼儀(Ming-Yii Huang) ； 黃鈞民(Chun-Ming Huang) ； 張鈺堂(Yu-Tang Chang) ； 王照元(Jaw-Yuan Wang)

《中華民國大腸直腸外科醫學會雜誌》 29卷3期 (2018/09) Pp. 115-125

https://doi.org/10.6312/SCRSTW.201809_29(3).10705

摘要

Aims. The aim of the study is to evaluate the feasibility, safety and shortterm oncological outcomes of robotic-assisted total mesorectal excision (TME) for patients with low-lying rectal cancer (≤ 5 cm from anal verge). Methods. We enrolled 52 patients with stages I-III low-lying rectal cancer undergoing robotic-assisted TME at a single institution between July 2013 and December 2016. Results. Of the 52 patients, 43 (82.7%) patients underwent preoperative concurrent chemoradiotherapy(CCRT). R0 resection was obtained in 49 (94.3%) patients. Circumferential resection margin (CRM) and distal resection margin (DRM) were positive in 3 (5.76%) and 1 (1.9%) patients respectively. The anastomotic leakage rate was 3.84% (2/52 patients). The overall complication rate was 25% (13/52 patients); most of these were mild and the patient recovered uneventfully. Conclusions. The results demonstrated that robotic-assisted TME is safe and feasible for patients with low-lying rectal cancer.

關鍵字

Robotic-assisted total mesorectal excision ； Low-lying rectal cancer ； R0 resection ； Circumferential resection margin

並列摘要

目的：本研究吾人欲分析低位直腸癌（距離肛門≤ 5 cm）病患接受達文西機械手臂輔助全直腸繫膜切除術之安全性及短期臨床成果。病人及方法自2013年7月到2016年12月期間，在高雄醫學大學附設中和紀念醫院，共有52位第一至三期低位直腸癌的病人接受達文西機械手臂輔助全直腸繫膜切除術。結果：在52位病人裡，其中43位（82.7%）有接受術前同步放射線化學治療。在52位病人裡，有49（94.3%）人達到R0切除。圓周切緣（CRM）陽性的病人有3位（5.76%）而遠端切緣（DRM）陽性的病人有1位（1.9%）。吻和滲漏率為3.84%（2/52）。手術併發症率是25%（13/52）。但沒有病人死於手術的併發症，大部分的病人的併發症經保守治療後都能自動康復。結論：結果顯示達文西機械手臂輔助全直腸繫膜切除術對低位直腸癌患者來說是合適且安全的。

並列關鍵字

達文西機械手臂輔助全直腸繫膜切除術 ； 低位直腸癌 ； R0切除 ； 圓周切緣

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