腹腔镜和机器人右半结肠切除术的比较:来自单一中心的见解。

IF 2 4区 医学 Q3 SURGERY
M A Yusufi, U Mateen, M Uneeb, M Gupta, N Muhibullah, N N Siddiqi
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引用次数: 0

摘要

简介:右半结肠切除术已经从开放的方式发展到微创的方式。腹腔镜右半结肠切除术(LRH)被广泛采用,但挑战仍然存在,特别是在复杂的解剖。机器人右半结肠切除术(RRH)提供了更高的精度和人体工程学,但仍在审查其比较优势。本研究在单中心框架内批判性地评估了LRH与RRH的围手术期结果。方法:在一所高等院校进行回顾性队列分析,回顾2021年1月至2024年12月的所有RRH病例,并将其与最近的LRH病例进行比较。纳入标准包括确诊恶性肿瘤接受选择性右半结肠切除术的成年人;排除疾病复发或急诊指征的患者。人口统计学、肿瘤特征、手术细节和短期结果采用适当的统计检验进行比较。结果:两组间的基线人口统计数据具有可比性。RRH组横结肠肿瘤发生率(n = 15, 37.5%)高于LRH组(n = 2.5, 5%) (p = 0.003)。两组患者的平均手术时间具有可比性(RRH组219.9mi vs LRH组206.8min; p = 0.277)。RRH显著减少了失血量(24天vs 50.1天;p < 0.001),更早恢复肠功能(1.9天vs 2.6天;p = 0.004),缩短了住院时间(3.5天vs 6.1天;p = 0.001)。淋巴结产量比较。结论:与LRH相比,RRH在恢复和止血方面具有可测量的益处。它在不延长手术时间的情况下提供了相同的短期肿瘤预后。我们的研究结果表明RRH可能更适合解剖复杂的病例。因此,需要进行更大规模的前瞻性研究,并进行长期随访。
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 laparoscopic and robotic right hemicolectomy: insights from a single centre.

Introduction: Right hemicolectomy has evolved from open to minimally invasive approaches. Laparoscopic right hemicolectomy (LRH) is widely adopted, yet challenges persist, particularly in complex dissections. Robotic right hemicolectomy (RRH) offers enhanced precision and ergonomics but remains under scrutiny for its comparative advantages. This study critically evaluates the perioperative outcomes of LRH vs RRH within a single-centre framework.

Methods: A retrospective cohort analysis was carried out at a single tertiary institution, reviewing all RRH cases from January 2021 to December 2024 and comparing them with the most recent LRH cases. Inclusion criteria encompassed adults undergoing elective right hemicolectomy for confirmed malignancy; patients with recurrent disease or emergency indications were excluded. Demographics, tumour characteristics, operative details and short-term outcomes were compared using appropriate statistical tests.

Results: The baseline demographics were comparable between the groups. Transverse colon tumours were more frequent in the RRH group (n = 15, 37.5%) than in the LRH group (n = 2, 5%) (p = 0.003). The mean operative time was comparable in both groups (219.9mi in RRH vs 206.8min in LRH; p = 0.277). RRH demonstrated significantly reduced blood loss (24 vs 50.1 m; p < 0.001), earlier return of bowel function (1.9 vs 2.6 days; p = 0.004), and a reduced hospital stay (3.5 vs 6.1 days; p = 0.001). Lymph node yield was comparable.

Conclusion: RRH offers measurable benefits in recovery and haemostasis as compared with LRH. It offers equivalent short-term oncological outcomes without prolonging the operative time. Our findings suggest RRH may be preferable for anatomically complex cases. Larger, prospective studies with a long-term follow-up period are therefore indicated.

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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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