机器人手术系统辅助下的结直肠癌经自然腔道取标本手术与常规辅助切口取标本手术的近期疗效对比研究  

Comparison of short-term efficacy between robot-assisted natural orifice specimen extraction surgery and conventionally-assisted incision surgery in laparoscopic resection of colorectal cancer

作　　者：王佳琦 李兴源 熊寰 常泽文 王子桐 燕国庆 丁可 袁子茗 乔天宇[1] 黄睿[1] 王贵玉[1] 汤庆超[1] Jiaqi Wang;Xingyuan Li;Huan Xiong;Zewen Chang;Zitong Wang;Guoqing Yan;Ke Ding;Ziming Yuan;Tianyu Qiao;Rui Huang;Guiyu Wang;Qingchao Tang(Department of Center of Cancer,Colorectal Oncological Surgery,the Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China)

机构地区：[1]哈尔滨医科大学附属第二医院肿瘤中心/结直肠肿瘤外科,150081

出　　处：《中华结直肠疾病电子杂志》2024年第2期121-128,共8页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：黑龙江省博士后科研启动金(LBH-Q21027)。

摘　　要：目的比较机器人无辅助切口NOSES组(R-NOSES)和机器人常规辅助切口组(R-LA)在结直肠癌治疗中的近期疗效差异。方法纳入203例于哈尔滨医科大学附属第二医院肿瘤中心行机器人辅助下结直肠癌根治术的患者的病例资料,包括患者的术前一般资料、手术相关资料、病理资料以及术后相关资料。对比分析R-NOSES和R-LA的近期疗效差异。结果本研究共纳入R-NOSES患者36例,R-LA患者167例。通过倾向性评分后,R-NOSES患者36例,R-LA患者25例,R-NOSES组的平均手术时间长于R-LA组(267.64±57.23 min vs. 239.80±33.68 min,t=-2.181,P=0.033)。R-NOSES组的平均术后住院时间(t=2.860,P=0.006)、平均术后进食流质食物时间(t=2.929,P=0.005)和平均术后首次排气时间(t=3.046,P=0.003)均短于R-LA组,R-NOSES组并发症比例较R-LA组少(χ^(2)=4.164,P=0.041),术后第一日疼痛评分低于R-LA组(t=2.994,P=0.005)。R-NOSES组术后躯体功能(t=-7.530,P<0.001)、角色功能(t=-6.359,P<0.001)、情绪功能(t=-4.812,P<0.001)恢复更好,整体健康情况优于R-LA组(t=-4.288,P<0.001)。结论与R-LA组相比,R-NOSES组虽然平均手术时间略有延长,但术后首次排气时间、术后首次进流食时间、术后住院时间均更短,术后并发症少,功能恢复更快,术后疼痛更少。ObjectiveTo compare the difference in recent efficacy between the robotic no-incision NOSES group (R-NOSES) and the robotic conventionally-assisted incision group (R-LA) in the treatment of colorectal cancer.MethodsA total of 203 patients who underwent robot-assisted radical colorectal cancer surgery at our center were included in this study, and the data collected included preoperative general data, surgery-related data, pathological data, and postoperative-related data of the patients. The difference in recent outcomes between robotic incisionless NOSES surgery and robotic conventional-assisted incision surgery was explored through comparative analyses.ResultsThis study included 36 patients with R-NOSES and 167 patients with R-LA. After propensity score matching, there were 36 patients in the R-NOSES group and 25 patients in the R-LA group. The mean operation time was longer in the R-NOSES group compared to the R-LA group (267.64±57.23 min vs. 239.80±33.68 min, t=-2.181, P=0.033). The mean postoperative hospital stay (t=2.860, P=0.006), mean time to first liquid food intake (t=2.929, P=0.005), and mean time to first bowel movement (t=3.046, P=0.003) were shorter in the R-NOSES group compared to the R-LA group. The proportion of postoperative complications was lower in the R-NOSES group (χ^(2)=4.164, P=0.041), and the pain score on the first postoperative day was lower (t=2.994, P=0.005). The physical function (t=-7.530, P<0.001), role function (t=-6.359, P<0.001), and emotional function (t=-4.812, P<0.001) recovered better in the R-NOSES group, and the overall health status was superior to that of the R-LA group (t=-4.288, P<0.001).ConclusionAlthough the mean operation time was slightly longer in the R-NOSES group compared to the R-LA group, the R-NOSES group had shorter times for first bowel movement, first liquid food intake, and hospital stay, fewer postoperative complications, faster functional recovery, and less postoperative pain.

关 键 词：结直肠肿瘤 机器人手术 经自然腔道取标本手术(NOSES) 微创外科 

分 类 号：R735.35[医药卫生—肿瘤]