摘要
We retrospectively collected data on 130 minimally invasive colon resection cases performed by the same surgeon from April 2005 to February 2017, of which 35 were completed laparoscopically and 95 were completed robotically. The first 30 robotic cases were allocated to a Training group to account for the learning needed to stabilize operative ability. The 35 laparoscopic cases and 65 of the 95 robotic cases, starting with the 31st case, were compared. Robotic partial colon resection was significantly more capable than the laparoscopic approach in limiting blood loss (p < 0.05) during the procedure, lessening conversion to a traditional open approach (p < 0.05), and produced a quantitatively larger lymph node harvest (p < 0.05). Patients of robotic cases also had overall shorter hospital stay (p < 0.05). Laparoscopic cases were significantly shorter in terms of operation time (p < 0.05). Laparoscopic and robotic approaches had similar rates of several aspects of morbidity and mortality. The robotic approach to partial colon resection is a technically capable modality of operation intraoperatively, as shown by increased lymph node harvest and less blood loss, and may provide some benefits to patients postoperatively, evidenced by shorter hospital stays, and potentially an oncologic benefit by obtaining higher lymph node harvest in cancer cases. Another benefit of the implementation of a robotic approach is the increased number of patients that are eligible for and ultimately undergo a safe and successful minimally invasive surgery as compared to a more traditional surgical approach.
We retrospectively collected data on 130 minimally invasive colon resection cases performed by the same surgeon from April 2005 to February 2017, of which 35 were completed laparoscopically and 95 were completed robotically. The first 30 robotic cases were allocated to a Training group to account for the learning needed to stabilize operative ability. The 35 laparoscopic cases and 65 of the 95 robotic cases, starting with the 31st case, were compared. Robotic partial colon resection was significantly more capable than the laparoscopic approach in limiting blood loss (p < 0.05) during the procedure, lessening conversion to a traditional open approach (p < 0.05), and produced a quantitatively larger lymph node harvest (p < 0.05). Patients of robotic cases also had overall shorter hospital stay (p < 0.05). Laparoscopic cases were significantly shorter in terms of operation time (p < 0.05). Laparoscopic and robotic approaches had similar rates of several aspects of morbidity and mortality. The robotic approach to partial colon resection is a technically capable modality of operation intraoperatively, as shown by increased lymph node harvest and less blood loss, and may provide some benefits to patients postoperatively, evidenced by shorter hospital stays, and potentially an oncologic benefit by obtaining higher lymph node harvest in cancer cases. Another benefit of the implementation of a robotic approach is the increased number of patients that are eligible for and ultimately undergo a safe and successful minimally invasive surgery as compared to a more traditional surgical approach.
