Learning Curve of Robotic Total Mesorectal Excision versus Transanal Total Mesorectal Excision - A Single-Center Study

Q4 Medicine
M. Karamanliev, T. Yotsov, D. Dimitrov
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引用次数: 0

Abstract

Introduction: Rectal cancer treatment has changed over the last several decades. Total mesorectal excision (TME) has proven to be the gold standard in rectal cancer surgery. Transanal total mesorectal excision (TaTME) and robotic total mesorectal excision (RoTME) for low and mid rectal cancer are implemented to overcome some of the difficulties of the laparoscopic approach. The aim of this study is to show a single-center experience in the learning curves of both RoTME and TaTME. Material and methods: A single-center prospective study comparing the first 17 consecutive RoTME cases from January 2016 to May 2019 to the first 16 consecutive cases of TaTME from July 2019 to June 2021 was conducted. The difference in the time periods is due to the later implementation of TaTME in the center. All procedures were performed by a single team. Results: A total of 33 patients were included in the study – 17 RoTME patients and 16 TaTME patients. The groups were homogeneously distributed in terms of patients’ characteristics and stage. Comparing the two groups, no statistically significant differences between them were found in terms of complication rates (p=0.692), positive circumferential resection margins rates (p=0.000), frequency of anastomotic leak rates (p=0.596), time from completion of radiotherapy to surgery (p=0.229) and time from surgery to ileostomy closure (p=0.880). A statistically significant shorter operative time was found in the TaTME group (p=0.008). Conclusion: The learning curve should be considered in all procedures. A structured training pathway for TaTME and RoTME is essential. No differences between robTME and TaTME in the learning curve were observed in our center.
机器人全肠系膜切除术与经肛门全肠系膜切除术的学习曲线-一项单中心研究
导读:在过去的几十年里,直肠癌的治疗方法发生了变化。全肠系膜切除(TME)已被证明是直肠癌手术的金标准。采用经肛门全肠系膜直肠切除术(TaTME)和机器人全肠系膜直肠切除术(RoTME)治疗中低位直肠癌,克服了腹腔镜手术的一些困难。本研究的目的是在RoTME和TaTME的学习曲线中显示单中心经验。材料和方法:采用单中心前瞻性研究,比较2016年1月至2019年5月连续17例RoTME病例和2019年7月至2021年6月连续16例TaTME病例。时间段的差异是由于该中心较晚实施了TaTME。所有程序均由一个小组完成。结果:共纳入33例患者,其中17例为RoTME患者,16例为TaTME患者。各组在患者特征和分期方面分布均匀。两组患者在并发症发生率(p=0.692)、环切缘阳性发生率(p=0.000)、吻合口漏频率(p=0.596)、放疗结束至手术时间(p=0.229)、手术至回肠造口时间(p=0.880)方面比较,差异均无统计学意义。TaTME组手术时间短,差异有统计学意义(p=0.008)。结论:所有手术均应考虑学习曲线。为TaTME和RoTME提供结构化的培训途径是必不可少的。在我们的中心,robTME和TaTME在学习曲线上没有差异。
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
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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