Abstract：
Robot-assisted laparoscopic anterior resection is a novel technique. However, evidence in the literature regarding the advantages of robot-assisted laparoscopic surgery (RLS) is insufficient. The aim of this study was to compare the outcomes of RLS versus conventional laparoscopic surgery (CLS) for the treatment of sigmoid colon cancer. We performed a retrospective study at the Northern Jiangsu People\'s Hospital. Patients diagnosed with sigmoid colon cancer and underwent anterior resection between January 2019 to September 2023 were included in the study. We compared the basic characteristics of the patients and the short-term and long-term outcomes of patients in the two groups. A total of 452 patients were included. Based on propensity score matching, 212 patients (RLS, n = 106; CLS, n = 106) were included. The baseline data in RLS group was comparable to that in CLS group. Compared with CLS group, RLS group exhibited less estimated blood loss (P = 0.015), more harvested lymph nodes (P = 0.005), longer operation time (P < 0.001) and higher total hospitalization costs (P < 0.001). Meanwhile, there were no significant differences in other perioperative or pathologic outcomes between the two groups. For 3-year prognosis, overall survival rates were 92.5% in the RLS group and 90.6% in the CLS group (HR 0.700, 95% CI 0.276-1.774, P = 0.452); disease-free survival rates were 91.5% in the RLS group and 87.7% in the CLS group (HR 0.613, 95% CI 0.262-1.435, P = 0.259). Compared with CLS, RLS for sigmoid colon cancer was found to be associated with a higher number of lymph nodes harvested, similar perioperative outcomes and long-term survival outcomes. High total hospitalization costs of RLS did not translate into better long-term oncology outcomes.
摘要：
机器人辅助腹腔镜前切除术是一项新技术。然而,文献中关于机器人辅助腹腔镜手术(RLS)优势的证据不足.这项研究的目的是比较RLS与传统腹腔镜手术（CLS）治疗乙状结肠癌的结果。我们在苏北人民医院进行了一项回顾性研究。2019年1月至2023年9月期间诊断为乙状结肠癌并接受前切除术的患者被纳入研究。我们比较了两组患者的基本特征以及患者的短期和长期预后。共纳入452例患者。基于倾向得分匹配，212名患者（RLS，n=106；CLS，包括n=106）。RLS组的基线数据与CLS组相当。与CLS组相比，RLS组显示出更少的估计失血（P=0.015），更多的收集淋巴结（P=0.005），手术时间更长（P<0.001），总住院费用更高（P<0.001）。同时,两组在其他围手术期或病理结局方面无显著差异.对于3年预后，RLS组的总生存率为92.5%,CLS组为90.6%(HR0.700,95%CI0.276-1.774,P=0.452);RLS组的无病生存率为91.5%,CLS组为87.7%(HR0.613,95%CI0.262-1.435,P=0.259).与CLS相比,发现乙状结肠癌的RLS与更多的淋巴结收集有关，相似的围手术期结局和长期生存结局.RLS的高总住院费用并没有转化为更好的长期肿瘤学结果。
