混合机器人直肠手术的可行性。

IF 1.6 4区 医学 Q2 SURGERY
Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-08 DOI:10.1007/s00595-025-03001-5
Hideya Kashihara, Takuya Tokunaga, Toshiaki Yoshimoto, Yuma Wada, Chie Takasu, Masaaki Nishi, Mitsuo Shimada
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引用次数: 0

摘要

目的:探讨机器人直肠手术联合经肛门全肠系膜切除(混合机器人手术)的可行性。方法:在2017 - 2022年进行的143例机器人直肠手术中,85例为混合机器人手术,并对其进行分析。该队列包括男性59人,女性26人,平均年龄65.8岁,平均体重指数22.6 kg/m2。c期20例为I期,21例为II期,36例为III期,4例为IV期,其他4例。手术类型为前低位切除21例,括约肌间切除27例,腹会阴切除32例,全盆腔切除2例,其他3例。12例(14.1%)患者接受了新辅助化疗或放化疗,39例(45.9%)患者接受了侧淋巴结清扫。结果:全肠系膜切除平均手术时间302.7 min,中位失血量71.5 ml,无中转开腹病例。术后住院时间中位数为15.9天。Clavien-Dindo分级≥3级并发症3例(4.2%)。发生尿功能障碍6例(8.3%)。3例(4.2%)患者被诊断为环周切除边缘阳性。结论:混合机器人手术是安全可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Feasibility of hybrid robotic rectal surgery.

Purpose: To investigate the feasibility of combined robotic rectal surgery and transanal total mesorectal excision (hybrid robotic surgery).

Methods: Among 143 robotic rectal surgeries performed from 2017 to 2022, 85 were hybrid robotic surgeries and were analyzed in this study. The cohort comprised 59 males and 26 females with a mean age of 65.8 years old and a mean body mass index of 22.6 kg/m2. The cStage was I in 20 cases, II in 21, III in 36, IV in 4, and other in 4. The operation types were low anterior resection in 21 cases, intersphincteric resection in 27, abdominoperineal resection in 32, total pelvic exenteration in 2, and other in 3. Twelve patients (14.1%) received neoadjuvant chemotherapy or chemoradiotherapy, and 39 (45.9%) underwent lateral lymph node dissection.

Results: The mean operation time for total mesorectal excision was 302.7 min, and the median blood loss was 71.5 ml. No cases required conversion to laparotomy. The median length of postoperative hospital stay was 15.9 days. Complications of Clavien-Dindo grade ≥ 3 occurred in 3 cases (4.2%). Urinary dysfunction occurred in 6 cases (8.3%). Three (4.2%) patients were diagnosed with positive circumferential resection margins.

Conclusion: Hybrid robotic surgery is safe and oncologically feasible.

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来源期刊
Surgery Today
Surgery Today 医学-外科
CiteScore
4.90
自引率
4.00%
发文量
208
审稿时长
1 months
期刊介绍: Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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