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对于直肠癌的外科和瘤结果,机器人辅助与腹腔镜切除术的比较

Wenpeng Wang¹, Jia Liu¹, Jiefu Wang¹

¹Department of Colorectal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Key Laboratory of Digestive Cancer, Tianjin, China.

Frontiers in surgery

|August 29, 2025

概括

机器人辅助切除术 (RAP) 在具有挑战性的病例中显示出更好的手术精度和更快的恢复,尽管相比于腹腔镜切除术 (LP),手术时间更长,成本更高. 这两种手术的长期存活率相似.

科学领域:

外科瘤学
最少的入侵性手术
结直肠癌治疗方法

背景情况:

机器人辅助切除术 (RAP) 正在成为直肠癌手术的流行.
与腹腔镜切除术 (LP) 相比,关于其长期益处的争论仍在继续.
临床等效性需要进一步验证,特别是在复杂的解剖学情况下.

研究的目的:

为了比较机器人辅助切除术 (RAP) 与腹腔镜切除术 (LP) 对直肠癌的结果.
评估手术精度,术后并发症,功能恢复和生存率.
在解剖学上具有挑战性的病例中评估RAP的有效性.

主要方法:

针对直肠癌进行RAP或LP的患者的回顾性分析.
在天津医科大学癌症研究所和医院从2019年到2024年收集的数据.
对手术时间,失血,费用,并发症,功能恢复和生存结果进行比较.

主要成果:

拉皮手术的手术时间较长, 输血量较大, 费用较高.
RAP显示严重并发症减少和复发率降低的趋势.
在对低直肠癌的亚组分析中,RAP显示出优异的环切除边缘 (CRM) 和中直肠完整性.
在小组分析中,RAP导致功能恢复速度更快 (腹和排尿).
在整体队列中,没有观察到无病生存期 (DFS) 或总生存期 (OS) 的显著差异.

结论:

RAP提供了更高的外科精度,特别是对于低直肠癌,并改善了CRM和中直肠保护.
尽管增加了手术时间和成本,但RAP在功能恢复和减少复发率方面显示出潜在的好处.
长期生存结果在RAP和LP之间是可比的,但RAP在特定场景中的优势需要进一步调查.

关键词:

腹腔镜检查乳腺切除术甲状腺癌甲状腺癌机器人手术程序生存分析

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