Abstract：
Although the safety and short-term outcomes of robotic surgery for sigmoid colon and rectal cancer patients are well-documented, there is limited research on the long-term survival outcomes of robotic colorectal surgery. This is a retrospective study that includes 502 patients who underwent either laparoscopic or robotic anterior resection and abdominoperineal resection for rectal or sigmoid colon cancer between August 2016 and September 2021. All patients were diagnosed with rectal or sigmoid colon adenocarcinoma. Propensity score matching (PSM) was implemented to minimize selection bias. Perioperative outcomes, complication rates, and pathological data were evaluated and compared. The 5-year overall survival rate and disease-free survival rate were calculated and compared. Before matching, patients in the robotic group had earlier pathological T and N stages and were more likely to have received neoadjuvant chemoradiotherapy compared to the laparoscopic group. After matching, most clinicopathological outcomes were similar between the two groups, but the robotic group had longer operative times and a lower conversion rate to open surgery compared with laparoscopic group. After matching for clinical factors, the 5-year DFS rates were 88.19% for the robotic group and 82.46% for the laparoscopic group (P = 0.122), and the OS rates were 90.5% and 79.5% (P = 0.342), showing no significant differences. In the stratified analysis, patients in the robotic surgery group had significantly higher 5-year DFS rates in the following subgroups: age < 65 years, TNM stage I-II, received neoadjuvant therapy, and primary tumor located in the rectum. The safety and efficacy of robotic surgery for sigmoid colon and rectal cancer were validated compared to laparoscopic surgery, with both groups of patients exhibiting comparable long-term prognoses.
摘要：
尽管机器人手术对乙状结肠和直肠癌患者的安全性和短期结果是有据可查的，关于机器人结直肠手术的长期生存结局的研究有限.这是一项回顾性研究，包括在2016年8月至2021年9月期间接受腹腔镜或机器人前切除术和腹部手术切除直肠或乙状结肠癌的502例患者。所有患者均诊断为直肠或乙状结肠腺癌。实施倾向得分匹配(PSM)以最小化选择偏差。围手术期结果,并发症发生率,和病理资料进行评价和比较。计算并比较5年总生存率和无病生存率。匹配之前,与腹腔镜组相比,机器人组患者的病理T和N分期较早,并且更有可能接受新辅助放化疗.匹配后,两组的大多数临床病理结果相似，但与腹腔镜组相比,机器人组手术时间更长,开腹手术的转化率更低.匹配临床因素后，机器人组5年DFS率为88.19%,腹腔镜组为82.46%(P=0.122),OS率分别为90.5%和79.5%(P=0.342),没有显着差异。在分层分析中，机器人手术组的患者在以下亚组中的5年DFS率明显较高：TNMI-II期,接受新辅助治疗,原发肿瘤位于直肠。与腹腔镜手术相比，机器人手术治疗乙状结肠和直肠癌的安全性和有效性得到了验证。两组患者的长期预后相当。
