完整的RAMIE与混合RAMIE:对结果评估和成本考虑的回顾性研究
Elettra Ugliono1, Fabrizio Rebecchi2, Sara Salomone3
1General Surgery and Center for Minimally Invasive Surgery, Department of Surgical Sciences, University of Torino, Corso A.M. Dogliotti 14, 10126, Turin, Italy. elettra.ugliono@unito.it.
Updates in surgery
|April 6, 2025
概括
完全机器人辅助的最小侵入性食道切除术 (F-RAMIE) 与混合方法 (H-RAMIE) 的安全性和有效性相提并论. F-RAMIE在淋巴结检索和减少ICU停留方面显示出好处,具有轻微的经济优势.
科学领域:
- 手术瘤学手术瘤学
- 最少侵入性的手术
- 机器人手术 机器人手术
背景情况:
- 最少侵入性食道切除术 (MIE) 是食道癌的标准治疗方法.
- 将全机器人辅助MIE (F-RAMIE) 与混合MIE (H-RAMIE) 进行比较,对于优化患者的治疗结果和资源利用至关重要.
研究的目的:
- 为了比较术后并发症,临床结果,瘤学结果和F-RAMIE与H-RAMIE的成本.
- 评估这两种MIE技术的安全性和有效性.
主要方法:
- 在2018年至2023年期间,对100名接受F-RAMIE或H-RAMIE的患者进行了多中心回顾性分析.
- 主要终点 (术后并发症) 和次要终点 (临床结果,瘤结果,成本) 的比较.
- 使用Kaplan-Meier方法和详细的经济评估进行生存分析.
主要成果:
- 与H-RAMIE相比,F-RAMIE的操作时间较长,但在重症监护室 (ICU) 的停留时间明显较短.
- 在转化率,整体术后并发症或住院时间方面没有发现显著差异.
- F-RAMIE显示了优异的淋巴结检索,而R0切除率,整体存活率和复发率在两组之间是可比的.
- 成本分析显示,F-RAMIE具有轻微的经济优势,主要是由于减少住院费用.
结论:
- 无论F-RAMIE和H-RAMIE对于食道切除术的并发症和瘤后果都同样安全有效.
- 在淋巴结产量和ICU恢复方面,F-RAMIE提供了优势,具有潜在的成本节约.
- 在F-RAMIE和H-RAMIE之间做出选择可能取决于特定的机构资源和患者因素.
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