Abstract:
The perioperative and short-term oncological outcomes of robotic-assisted rectal surgery (RRS) are unclear. This retrospective observational study enrolled patients with rectal adenocarcinoma undergoing RRS from three high-volume institutions in Taiwan. Of the 605 enrolled patients, 301 (49.75%), 176 (29.09%), and 116 (19.17%) had lower, middle, and upper rectal cancers, respectively. Low anterior resection (377, 62.31%) was the most frequent surgical procedure. Intraoperative blood transfusion was performed in 10 patients (2%). The surgery was converted to an open one for one patient (0.2%), and ten (1.7%) patients underwent reoperation. The overall complication rate was 14.5%, including 3% from anastomosis leakage. No deaths occurred during surgery and within 30 days postoperatively. The positive rates of distal resection margin and circumferential resection margin were observed in 21 (3.5%) and 30 (5.0%) patients, respectively. The 5-year overall and disease-free survival rates for patients with stage I-III rectal cancer were 91.1% and 86.3%, respectively. This is the first multi-institutional study in Taiwan with 605 patients from three high-volume hospitals. The overall surgical and oncological outcomes were equivalent or superior to those estimated in other studies. Hence, RRS is an effective and safe technique for rectal resection in high-volume hospitals.
摘要:
机器人辅助直肠手术(RRS)的围手术期和短期肿瘤学结果尚不清楚。这项回顾性观察性研究纳入了台湾三家高容量机构接受RRS的直肠腺癌患者。在605名登记的患者中,301(49.75%),176(29.09%),和116(19.17%)较低,中间,和上直肠癌,分别。低位前切除术(377,62.31%)是最常见的外科手术。术中输血10例(2%)。一名患者(0.2%)将手术转换为开放性手术,10例(1.7%)患者接受了再次手术。总并发症发生率为14.5%,包括3%的吻合口漏。手术期间和术后30天内无死亡病例发生。远端切缘和环周切缘阳性率分别为21例(3.5%)和30例(5.0%),分别。I-III期直肠癌患者的5年总体生存率和无病生存率分别为91.1%和86.3%,分别。这是台湾首个多机构研究,共有来自三家大批量医院的605名患者。总体手术和肿瘤结果与其他研究中估计的结果相当或优于其他研究。因此,RRS是高容量医院直肠切除术的有效且安全的技术。