Impact of team experience on robot-assisted surgery for rectal cancer: A comparative study

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola Pub Date : 2025-02-01 DOI:10.1016/j.ciresp.2024.10.012

Ernesto Barzola , Pere Planellas , Lidia Cornejo , Nuria Gómez , David Julià , Kelly-Ann Bobb , Ramón Farrés , Marcos Gómez

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引用次数: 0

Abstract

Introduction

The robotic surgical team in the operating room plays an important role in determining the outcome of a robotic approach. This study aimed to compare the outcomes of 2 hospitals with different levels of expertise in robot-assisted rectal cancer surgery.

Methods

This retrospective study analyzed 195 patients who underwent robot-assisted rectal resection at 2 referral centers for the treatment of rectal cancer between March 2018 and December 2021.

Results

In total, 195 patients had undergone robotic rectal cancer surgery: 95 performed by an expert team, and 100 by a novel team. The expert team performed more low anterior resections (55.8%) than the novel team (33%) (P = 0.001), and the total operative time varied significantly between the groups (P < 0.001). The novel team’s operative time was 135 min longer than the expert team’s. The expert team had no conversions to open surgery, while the novel team had an 8% conversion rate (P = 0.007). In this study, overall morbidity was 45.3% among patients treated by the expert team versus 38% among those treated by the novice team (P = 0.304). Severe complications (Clavien–Dindo grade >IIIB) occurred at a rate of 10% in both groups. Incomplete mesorectal excision was observed in 3.2% of the expert team’s patients versus 4.2% of the novice team’s (P = 0.65).

Conclusion

The expert team achieved a shorter operative time and less conversion to open surgery. However, the morbidity and pathological outcomes were comparable between the teams. The introduction of robotic surgery in a team with early-stage surgical experience was safe.

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团队经验对机器人辅助直肠癌手术的影响：比较研究

手术室的机器人手术团队在决定机器人入路的结果方面起着重要的作用。本研究旨在比较两家具有不同专业水平的医院在机器人辅助直肠癌手术中的结果。方法本回顾性研究分析了2018年3月至2021年12月期间在2个转诊中心接受机器人辅助直肠切除术治疗的195例直肠癌患者。结果共195例患者接受了机器人直肠癌手术，其中95例由专家团队完成，100例由新团队完成。专家组下前路切除术发生率（55.8%）高于新组（33%）（P = 0.001），两组间总手术时间差异显著（P < 0.001）。新组手术时间比专家组长135分钟。专家小组没有转诊到开腹手术，而新小组转诊率为8% （P = 0.007）。在本研究中，专家组治疗的患者总发病率为45.3%，新手治疗的患者总发病率为38% （P = 0.304）。两组的严重并发症发生率均为10% （Clavien-Dindo分级>；IIIB）。专家组中3.2%的患者不完全切除肠系膜，而新手组中4.2%的患者不完全切除肠系膜（P = 0.65）。结论专家组手术时间短，转开手术次数少。然而，两组之间的发病率和病理结果是相似的。在具有早期手术经验的团队中引入机器人手术是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.