Comparison of Postoperative Outcomes and Long-Term Survival Rates between Patients Who Underwent Robotic and Laparoscopic Complete Mesocolic Excision for Right-Sided Colon Cancer.

IF 1.1 4区 医学 Q3 SURGERY
Afag Aghayeva, Mustafa Ege Seker, Serra Bayrakceken, Ebru Kirbiyik, Aysegul Bagda, Cigdem Benlice, Tayfun Karahasanoglu, Bilgi Baca
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引用次数: 0

Abstract

Introduction: Right colon cancer often requires surgical intervention, and complete mesocolic excision (CME) has emerged as a standard procedure. The study aims to evaluate and compare the safety and efficacy of robotic and laparoscopic CME for patients with right colon cancer and 5-year survival rates examined to determine the outcomes. Materials and Methods: Patients who underwent CME for right-sided colon cancer between 2014 and 2021 were included in this study. Group differences of age, body mass index, operation time, bleeding amount, total harvested lymph nodes, and postoperative stay were analyzed by the Mann-Whitney U test. Group differences of sex, American Society of Anesthesiology, and tumor, node, and metastasis stage were analyzed by the Chi-squared test. Disease-free and overall survival were assessed using Kaplan-Meier curves with the log-rank Mantel-Cox test. Results: From 109 patients, 74 of them were 1:1 propensity score matched and used for analysis. Total harvested lymph node (P ≤ .001) and estimated blood loss (P = .031) were found to be statistically significant between the groups. We found no statistically significant difference between the groups in terms of disease-free and overall survival (P = .27, .86, respectively), and the mortality rate was 9.17%, with no deaths directly attributed to the surgery. Conclusions: Study shows that minimally invasive surgery is a feasible option for CME in right colon cancers, with acceptable overall survival rates. Although the robotic approach has a higher lymph node yield, there was no significant difference in survival rates. Further randomized trials are needed to determine the clinical significance of both approaches.

右侧结肠癌机器人和腹腔镜中结肠完全切除术患者术后效果和长期生存率的比较
简介:右侧结肠癌通常需要手术干预,完全结肠系膜切除术(CME)已成为一种标准手术。本研究旨在评估和比较机器人和腹腔镜 CME 对右侧结肠癌患者的安全性和有效性,并通过检查 5 年生存率来确定结果。材料和方法:本研究纳入了 2014 年至 2021 年期间接受 CME 治疗的右侧结肠癌患者。采用 Mann-Whitney U 检验分析年龄、体重指数、手术时间、出血量、收获淋巴结总数和术后住院时间的组间差异。性别、美国麻醉学会、肿瘤、结节和转移分期的组间差异采用卡方检验。无病生存率和总生存率通过卡普兰-梅耶曲线和对数秩曼特尔-考克斯检验进行评估。结果在109名患者中,有74人进行了1:1倾向评分匹配并用于分析。结果发现,两组患者的总淋巴结摘除率(P ≤ .001)和估计失血量(P = .031)具有统计学意义。在无病生存率和总生存率方面,我们发现组间差异无统计学意义(P = 0.27,0.86),死亡率为 9.17%,没有直接因手术导致的死亡。结论:研究表明,微创手术是治疗右结肠癌 CME 的可行方案,总生存率可接受。虽然机器人方法的淋巴结产量较高,但生存率并无显著差异。要确定这两种方法的临床意义,还需要进一步的随机试验。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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