机器人辅助和腹腔镜右半结肠切除术治疗右侧结肠癌的比较:使用倾向评分匹配的短期围手术期结果报告

IF 0.9 Q4 ORTHOPEDICS
Shunsuke Sakuraba, Mizuki Nishiko, Shingo Yamasaki, Kazumasa Nakamura, Kohei Koido, Takeshi Oshima, Hiroyuki Hazama, Kou Ohata, Hideyuki Kanemto
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引用次数: 0

摘要

机器人辅助右半结肠切除术作为一种微创手术,可以提供精确的淋巴结清扫和减少手术压力,已经得到了广泛的应用。然而,比较其与传统腹腔镜右半结肠切除术的优势的数据仍然有限。本研究旨在阐明机器人辅助右半结肠切除术治疗结肠癌的安全性和有效性。方法回顾性分析2019年1月至2024年12月接受右半结肠切除术的患者。从一开始就进行开放切除、急诊手术、D1或下淋巴结清扫的患者被排除在外。倾向评分匹配平衡基线特征,如年龄、性别、体重指数、ASA-PS、肿瘤位置和临床分期。我们比较了机器人辅助组和腹腔镜组的围手术期结果。结果共有158例患者符合标准,并建立了具有可比性特征的匹配队列。两组间Clavien-Dindo II级及以上并发症及住院时间无显著差异。然而,机器人辅助组术中出血量更少,体内吻合率更高,淋巴结回收更广泛。手术时间相似,并且在机器人辅助组中没有发生转向开放手术的情况。结论机器人辅助右半结肠切除术可以安全进行,不会增加术后并发症,也不会延长手术时间。它的潜在优势——减少失血和改善淋巴结清扫——值得在更大的多中心试验中进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Robot-Assisted and Laparoscopic Right Hemicolectomy for Right-Sided Colon Cancer: A Report on the Short-Term Perioperative Outcomes Using Propensity Score Matching

Background

Robot-assisted right hemicolectomy has gained popularity as a minimally invasive procedure that may provide precise lymph node dissection and reduced surgical stress. However, data comparing its advantages to conventional laparoscopic right hemicolectomy remain limited. This study aimed to clarify the safety and efficacy of robot-assisted right hemicolectomy for colon cancer.

Methods

We retrospectively analyzed patients who underwent right hemicolectomy between January 2019 and December 2024. Patients who had open resections from the outset, emergency surgeries, or D1 or lower lymph node dissection were excluded. Propensity score matching balanced baseline characteristics such as age, sex, body mass index, ASA-PS, tumor location, and clinical stage. We compared perioperative outcomes between robot-assisted and laparoscopic groups.

Results

A total of 158 patients met the criteria, and matched cohorts were created with comparable characteristics. There was no significant difference in Clavien–Dindo Grade II or higher complications or hospital stay length between groups. However, the robot-assisted group had lower intraoperative blood loss, higher intracorporeal anastomosis rates, and more extensive lymph node retrieval. Operative times were similar, and no conversions to open surgery occurred in the robot-assisted group.

Conclusions

Robot-assisted right hemicolectomy can be performed safely without increasing postoperative complications or prolonging operative time. Its potential advantages—reduced blood loss and improved lymph node dissection—warrant further investigation in larger multicenter trials.

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