Comparative Outcomes of Robot-assisted Versus Laparoscopic Low Anterior Resection in Mid-to-low Rectal Cancer: A Propensity Score-matched Study on Complications and Permanent Stoma Rates.

IF 1.8 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
In vivo Pub Date : 2025-07-01 DOI:10.21873/invivo.14037
Hsin Hsu, Jeng-Fu You, Chun-Kai Liao, Tzong-Yun Tsai, Shu-Huan Huang
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引用次数: 0

Abstract

Background/aim: While some research has revealed the potential short-term advantages of robot-assisted low anterior resection (LAR) in patients with mid-to-low rectal cancer, studies focusing on the permanent stoma rate remain limited.

Patients and methods: We conducted a retrospective analysis on a continuous series of patients with non-metastatic mid-to-low rectal cancer. Between 2016 and 2020, these patients underwent either robot-assisted or traditional laparoscopic LAR at a single center. We used a propensity score matching technique, and the participants were matched in a 1:2 ratio and a caliper of 0.05.

Results: After matching, our cohort consisted of 44 patients from the robot-assisted LAR group and 88 from the laparoscopic LAR group. The long-term results, such as overall survival, cancer-free survival, and local and distant recurrence rates were similar between the two groups. However, the robot-assisted group exhibited a notably shorter average post-surgery hospitalization (10.8 vs. 16.7 days, p=0.001), reduced incidence of anastomotic leakage (11.4% vs. 37.5%, p<0.001), fewer patients requiring a permanent stoma (13.6% vs. 29.5% p=0.044), and significantly lower occurrences of grade III Clavien-Dindo surgical complications. Furthermore, the robot-assisted procedures had a diminished frequency of firing three or more staplers (2.3% vs. 26.1%, p=0.001). A multivariate logistic regression indicated that robot-assisted LAR is independently associated with a reduced risk of permanent stoma (odds ratio=0.28, p=0.033, 95% confidence interval=0.087-0.901).

Conclusion: In patients with mid-to-low rectal cancer, robot-assisted LAR, despite comparable long-term survival and recurrence rates, displayed reduced complications, including fewer instances of anastomotic leakage and permanent stoma requirements than its laparoscopic counterpart. These findings imply the potential superiority of robot-assisted surgical techniques for mid-to-low rectal patients.

机器人辅助与腹腔镜低位前切除术治疗中低位直肠癌的比较结果:并发症和永久造口率的倾向评分匹配研究
背景/目的:虽然一些研究揭示了机器人辅助下低位前切除术(LAR)在中低位直肠癌患者中的潜在短期优势,但关注永久性造口率的研究仍然有限。患者和方法:我们对一系列非转移性中低位直肠癌患者进行了回顾性分析。在2016年至2020年期间,这些患者在一个中心接受了机器人辅助或传统腹腔镜LAR。我们使用倾向评分匹配技术,参与者以1:2的比例和0.05的卡尺进行匹配。结果:经过匹配,我们的队列包括来自机器人辅助LAR组的44名患者和来自腹腔镜LAR组的88名患者。两组之间的长期结果,如总生存率、无癌生存率、局部和远处复发率相似。然而,机器人辅助组的术后平均住院时间明显缩短(10.8天vs. 16.7天,p=0.001),吻合口漏发生率降低(11.4% vs. 37.5%, p=0.001)。29.5% p=0.044), III级Clavien-Dindo手术并发症发生率显著降低。此外,机器人辅助手术发射三个或更多订书机的频率降低(2.3%对26.1%,p=0.001)。多因素logistic回归显示,机器人辅助的LAR与永久性造口风险降低独立相关(优势比=0.28,p=0.033, 95%可信区间=0.087-0.901)。结论:在中低位直肠癌患者中,机器人辅助的LAR尽管长期生存率和复发率相当,但其并发症更少,包括吻合口漏和永久造口需求比腹腔镜手术更少。这些发现暗示了机器人辅助手术技术在中低位直肠患者中的潜在优势。
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来源期刊
In vivo
In vivo 医学-医学:研究与实验
CiteScore
4.20
自引率
4.30%
发文量
330
审稿时长
3-8 weeks
期刊介绍: IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.
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