目的探讨达芬奇机器人结直肠癌根治术的可行性及近期疗效。方法400例结直肠癌患者,198例接受机器人手术,202例行腹腔镜手术。术后中位随访15.2(4~28)个月。回顾性分析比较两组患者手术情况及短期疗效。结果与腹腔镜组相比,机器人组患者术失血量显著较少、淋巴结清扫数目显著较多、手术时间显著较长(均P〉0.05);两组的术后胃肠道功能恢复时间、术后住院时间及并发症发生率,差异无统计学意义(均P〉0.05)。随访期间,机器人组复发转移10例,死亡4例;腹腔镜组复发转移18例,死亡8例。结论对比腹腔镜结直肠癌切除术,达芬奇机器人结直肠癌根治术能获得较大的淋巴结清扫范围,且出血量少、安全、可行。
Objective To evaluate the technical feasibility and short-term outcomes of robotic colorectal cancer resection. Methods 198 of the 400 patients with colorectal cancer underwent colorectal cancer resection by Leonardo Robot and 202 of the 400 patients underwent laparoscopic colorectal cancer resection. Follow-up was conducted for 15.2 (4 - 28)months. The short-term postoperative outcomes were compared. Results Compared with the laparoscopic group, the robotic group had less intraoperative blood loss, larger numbers of retrieved lymph nodes, and longer operation time significantly (all P 〈0.05).There were no significant differences in the gastrointestinal function recoverytime, postoperative hospital stay, and incidence of complications between these 2 groups (all P 〉0.05). During the follow-up period of 15.1 months, 10 patients experienced relapse and metastasis and 4 patients died of the disease in the robotic group, while 18 patients experienced relapse and metastasis and 8 died of the disease in the laparoscopic group. Conclusion Robotic system is feasible and safe in the treatment of colorectal cancer resection with the benefits of adequate lymphadenectomy and less intraoperative blood loss.