Pedja Cuk, Mindaugas Tiskus, Sören Möller, Kate Lykke Lambertsen, Christian Backer Mogensen, Michael Festersen Nielsen, Per Helligsø, Ismail Gögenur, Mark Bremholm Ellebæk
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引用次数: 0
摘要
背景:机器人技术的常规使用及其对结肠癌手术短期疗效的影响尚缺乏证据。本研究旨在比较机器人辅助或腹腔镜结肠癌手术患者的手术诱导系统应激反应以及临床和患者报告的结果:在这项于2021年8月至2023年3月完成的双盲优效RCT中,1-3期结肠癌患者按1:1的比例随机接受机器人辅助或腹腔镜结肠癌手术。主要结果是全身应激反应的变化,以术后前三天的 C 反应蛋白表达为特征。次要结果是术中、术后并发症和患者报告结果。后者包括恢复质量-15 和使用视觉模拟量表的疼痛强度:本研究共筛选出128名患者,其中50名患者(机器人辅助组和腹腔镜组各25名)被纳入最终随访和分析。腹腔镜组术后第一天的C反应蛋白反应较高(平均差异=19.88毫克/升,95% c.i.3.89-35.86;P=0.045)。术后第二和第三天的C反应蛋白表达差异无统计学意义:结论:采用机器人辅助手术治疗 1-3 期结肠癌可降低手术应激反应:NCT04687384 (http://www.clinicaltrials.gov)。
Surgical stress response in robot-assisted versus laparoscopic surgery for colon cancer (SIRIRALS): randomized clinical trial.
Background: Evidence for the routine use of robotic technology and its impact on short-term outcomes in colon cancer surgery is lacking. The aim of this study was to compare the surgically induced systemic stress response and clinical and patient-reported outcomes for patients undergoing robot-assisted or laparoscopic colon cancer surgery.
Methods: In this double-blinded superiority RCT completed between August 2021 and March 2023, patients with stage 1-3 colon cancer were randomized in a 1 : 1 ratio to undergo either robot-assisted or laparoscopic colon cancer surgery. The primary outcome was changes in the systemic stress response, characterized by C-reactive protein expression in the first three postoperative days. Secondary outcomes were intraoperative and postoperative complications and patient-reported outcomes. The latter included quality of recovery-15 and pain intensity using a visual analogue scale.
Results: In total, 128 patients were screened for potential inclusion in this study; 50 patients (25 in the robot-assisted group and 25 in the laparoscopic group) were included in the final follow-up and analysis. The postoperative C-reactive protein response was higher on the first postoperative day in the laparoscopic group (mean difference = 19.88 mg/l, 95% c.i. 3.89-35.86; P = 0.045). No statistically significant differences were noted for C-reactive protein expression on the second and third postoperative days.
Conclusion: Adopting robot-assisted surgery for stage 1-3 colon cancer is associated with a reduction in the surgical stress response.
期刊介绍:
The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology.
While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.