A Comparative Study of Short-term Clinical Outcome of Robotic vs. Laparoscopic Surgery for Rectal Cancer

對於直腸癌使用機器人手臂輔助與腹腔鏡輔助手術兩者比較：短期經驗分享

林志衛(Chih-Wei Lin) ； 黃玄遠(Xuan-Yuan Huang) ； 張譽耀(Yu-Yao Chang)

《中華民國大腸直腸外科醫學會雜誌》 30卷3期 (2019/09) Pp. 97-103

https://doi.org/10.6312/SCRSTW.201909_30(3).10804

摘要

Purpose. In this study, we aimed to compare surgical parameters and short-term postoperative clinical outcomes of robotic vs. laparoscopic rectal cancer surgery. Methods. From May 2016 to Nov 2018, we retrospectively reviewed 46 patients who underwent robotic and laparoscopic rectal cancer surgery at our institution by a single surgeon. Patient characteristics and perioperative demographic data were collected and short-term clinical outcomes were compared, including TNM stage, preoperative chemoradiotherapy, postoperative radiotherapy, surgical parameters and postoperative outcomes. Results. Of 46 total patients, 21 underwent robotic surgery and the remaining 25 underwent laparoscopic rectal cancer surgery. There was no significant difference in patient characteristics between surgical groups. Mean operative time was longer in robotic surgery than laparoscopic surgery (robotic: 301.4 vs. laparoscopic: 206 min, p ＜ 0.001); mean estimated blood loss was not statistically different (robotic＂ 101.9 vs. 72.8 ml, p = 0.334). No significant difference was detected with regard to pathological outcome or postoperative complications. Conclusion. Robotic rectal cancer surgery had greater operative time but made no difference in postoperative short-term complication and outcome compared with laparoscopic rectal cancer surgery, which offers another safe, operative method.

關鍵字

Robotic ； Laparoscopic ； Rectal cancer ； Outcome

並列摘要

目的：對於機器人手臂輔助及腹腔鏡輔助手術切除直腸癌，術中與術後預後比較。方法：自2016年5月至2018年11月，共46位直腸癌患者接受單一手術醫師進行機器人手臂及腹腔鏡手術的回顧性研究。結果：共46位直腸癌患者納入研究，21位施行機器人手臂輔助手術，25位施行腹腔鏡輔助手術。平均手術時間機器人手臂組對比腹腔鏡組較長（301.4 vs. 206分鐘，p ＜0.001），術中出血量沒有顯著差異（101.9 vs. 72.8毫升，p = 0.334）。病患基本資料，合併症，術前腫瘤指數，術中淋巴結摘除數量，術後併發症，病理結果，住院天數，術後進食時間及術後30天內再住院率及死亡率兩組沒有差異。結論：機器人手臂輔助直腸癌手術相較腹腔鏡手術的花費的手術時間較長，但對於術中及術後併發症及預後並無顯著差異，因此相較腹腔鏡手術，仍是一個安全的手術方式。

並列關鍵字

機器人手臂 ； 腹腔鏡 ； 直腸癌 ； 預後

參考文獻

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