PDF(Pubmed)
Abstract：
BACKGROUND: Diverting colostomy followed by neoadjuvant treatment is a treatment of choice for obstructive rectal cancer. Such patients may be treated via a robotic approach with several advantages over conventional laparoscopic surgery. Conversely, the existing stoma may interfere with the optimal trocar position and thus affect the quality of robotic surgery. Moreover, the console surgeon does not face the patient, which may endanger the stoma.
METHODS: Patients with rectal cancer who underwent sphincter-preserving surgery were retrospectively investigated using a robotic platform after neoadjuvant treatment at our hospital. Based on pretreatment stoma creation, patients were divided into the NS (those without a stoma) and S groups (patients with a stoma). Baseline characteristics, types of neoadjuvant treatment, short-term surgical outcomes, postoperative anorectal manometric data, and survival were compared between the groups.
RESULTS: The NS and S groups comprised 65 and 9 patients, respectively. Conversion to laparotomy was required in three patients in the NS group. The S group required a longer console time than the NS group (median: 367 vs. 253 min, respectively, p = 0.038); however, no difference was observed in the total operative time (p = 0.15) and blood loss (p = 0.70). Postoperative complication rates, anorectal function, and oncological outcomes were similar between the groups.
CONCLUSIONS: Although console time was longer in patients with a stoma, robotic surgery could be performed safely like in those without a stoma after neoadjuvant treatment.
METHODS: Patients with rectal cancer who underwent sphincter-preserving surgery were retrospectively investigated using a robotic platform after neoadjuvant treatment at our hospital. Based on pretreatment stoma creation, patients were divided into the NS (those without a stoma) and S groups (patients with a stoma). Baseline characteristics, types of neoadjuvant treatment, short-term surgical outcomes, postoperative anorectal manometric data, and survival were compared between the groups.
RESULTS: The NS and S groups comprised 65 and 9 patients, respectively. Conversion to laparotomy was required in three patients in the NS group. The S group required a longer console time than the NS group (median: 367 vs. 253 min, respectively, p = 0.038); however, no difference was observed in the total operative time (p = 0.15) and blood loss (p = 0.70). Postoperative complication rates, anorectal function, and oncological outcomes were similar between the groups.
CONCLUSIONS: Although console time was longer in patients with a stoma, robotic surgery could be performed safely like in those without a stoma after neoadjuvant treatment.
摘要：
背景：转移结肠造口术后新辅助治疗是梗阻性直肠癌的首选治疗方法。可以通过机器人方法治疗这样的患者,其具有优于常规腹腔镜手术的几个优点。相反，现有的造口可能会干扰套管针的最佳位置，从而影响机器人手术的质量。此外，控制台外科医生不面对病人，这可能会危及造口。
方法：在我院接受新辅助治疗后，使用机器人平台对接受保括约肌手术的直肠癌患者进行回顾性调查。基于预处理造口的创建，患者分为NS组(无造口组)和S组(有造口组).基线特征，新辅助治疗的类型，短期手术结果，术后肛门直肠测压数据，比较各组之间的生存率。
结果：NS组和S组包括65和9名患者，分别。NS组的三名患者需要转换为剖腹手术。S组比NS组需要更长的控制台时间(中位数：367vs.253分钟,分别,p=0.038)；然而，总手术时间(p=0.15)和失血量(p=0.70)无差异.术后并发症发生率,肛门直肠功能，两组之间的肿瘤结局相似.
结论：尽管造口患者的控制台时间较长，机器人手术可以像新辅助治疗后没有造口的人一样安全地进行.
方法：在我院接受新辅助治疗后，使用机器人平台对接受保括约肌手术的直肠癌患者进行回顾性调查。基于预处理造口的创建，患者分为NS组(无造口组)和S组(有造口组).基线特征，新辅助治疗的类型，短期手术结果，术后肛门直肠测压数据，比较各组之间的生存率。
结果：NS组和S组包括65和9名患者，分别。NS组的三名患者需要转换为剖腹手术。S组比NS组需要更长的控制台时间(中位数：367vs.253分钟,分别,p=0.038)；然而，总手术时间(p=0.15)和失血量(p=0.70)无差异.术后并发症发生率,肛门直肠功能，两组之间的肿瘤结局相似.
结论：尽管造口患者的控制台时间较长，机器人手术可以像新辅助治疗后没有造口的人一样安全地进行.
