Colorectal Dis:结肠癌高风险患者手术方法对围手术期结局的影响——腹腔镜vs机器人辅助

2017-12-04 zhangfan MedSci原创

研究认为,对于直肠癌高危患者,机器人辅助手术的保肛率高,出血减少,开腹风险低,手术及住院时间缩短

近日研究人员比较了腹腔镜手术和机器人辅助手术对直肠癌高危患者围手术期结局的影响。

研究对2013年5月至2015年11月接受直肠癌手术的高危患者进行前瞻性数据分析。高风险患者定义为:体重指数≥30,男性,术前放化疗,肛门边缘与肿瘤腹部手术距离小于8厘米。

总计184名高风险患者参与研究,99人接受机器人辅助治疗,85人接受腹腔镜手术。研究发现,接受机器人辅助手术的患者其高位括约肌保存率更高(86% vs 74%,P = 0.045)、手术(240 vs 270 min, P = 0.013)及住院时间(7 vs 9 天,P = 0.001)缩短、失血量更少(10 vs 100 ml,P < 0.001)并且开腹手术风险降低(0% vs 5%,P = 0.043)。组间再手术、吻合口漏率、30天死亡率和肿瘤的预后无显著差异。

研究认为,对于直肠癌高危患者,机器人辅助手术的保肛率高,出血减少,开腹风险低,手术及住院时间缩短。

原始出处:

J. Ahmed et al. Robotic vs laparoscopic rectal surgery in high-risk patients. Colorectal Dis. 1 December 2017.

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    2018-07-19 shalley66
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createdName=shalley66, createdTime=Thu Jul 19 06:10:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053800, encodeId=d02f205380048, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Mon Mar 05 19:10:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012498, encodeId=3080201249826, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Nov 11 06:10:00 CST 2018, time=2018-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849568, encodeId=f6741849568ec, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Thu Aug 16 12:10:00 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276399, encodeId=b03b12e63993c, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321993, encodeId=0dab132199354, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391751, encodeId=6eea1391e5192, content=<a href='/topic/show?id=eb615005c7' target=_blank style='color:#2F92EE;'>#Colorectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5005, encryptionId=eb615005c7, topicName=Colorectal)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465792, encodeId=53b31465e92ff, content=<a href='/topic/show?id=b5765443896' target=_blank style='color:#2F92EE;'>#手术方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54438, encryptionId=b5765443896, topicName=手术方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5506759018, createdName=yangcx0917, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1513313, encodeId=398c15133139e, content=<a href='/topic/show?id=6a446120454' target=_blank style='color:#2F92EE;'>#机器人辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61204, encryptionId=6a446120454, topicName=机器人辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=324410545094, createdName=124987a0m69(暂无昵称), createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=)]
    2018-11-11 cmj8wellington
  5. [GetPortalCommentsPageByObjectIdResponse(id=1862044, encodeId=3f001862044c7, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Sat May 05 17:10:00 CST 2018, time=2018-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999148, encodeId=48ac199914898, content=<a href='/topic/show?id=70e1152462e' target=_blank style='color:#2F92EE;'>#Rectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15246, encryptionId=70e1152462e, topicName=Rectal)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f378286, createdName=shalley66, createdTime=Thu Jul 19 06:10:00 CST 2018, time=2018-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053800, encodeId=d02f205380048, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Mon Mar 05 19:10:00 CST 2018, time=2018-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2012498, encodeId=3080201249826, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Nov 11 06:10:00 CST 2018, time=2018-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849568, encodeId=f6741849568ec, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Thu Aug 16 12:10:00 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276399, encodeId=b03b12e63993c, content=<a href='/topic/show?id=768685612db' target=_blank style='color:#2F92EE;'>#腹腔镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85612, encryptionId=768685612db, topicName=腹腔镜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=xinxin088, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321993, encodeId=0dab132199354, content=<a href='/topic/show?id=890c611854e' target=_blank style='color:#2F92EE;'>#机器人#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61185, encryptionId=890c611854e, topicName=机器人)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391751, encodeId=6eea1391e5192, content=<a href='/topic/show?id=eb615005c7' target=_blank style='color:#2F92EE;'>#Colorectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5005, encryptionId=eb615005c7, topicName=Colorectal)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465792, encodeId=53b31465e92ff, content=<a href='/topic/show?id=b5765443896' target=_blank style='color:#2F92EE;'>#手术方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54438, encryptionId=b5765443896, topicName=手术方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5506759018, createdName=yangcx0917, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1513313, encodeId=398c15133139e, content=<a href='/topic/show?id=6a446120454' target=_blank style='color:#2F92EE;'>#机器人辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61204, encryptionId=6a446120454, topicName=机器人辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=324410545094, createdName=124987a0m69(暂无昵称), createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=)]
    2018-08-16 windight
  6. [GetPortalCommentsPageByObjectIdResponse(id=1862044, encodeId=3f001862044c7, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Sat May 05 17:10:00 CST 2018, time=2018-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999148, encodeId=48ac199914898, content=<a href='/topic/show?id=70e1152462e' target=_blank style='color:#2F92EE;'>#Rectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15246, encryptionId=70e1152462e, topicName=Rectal)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f378286, 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391751, encodeId=6eea1391e5192, content=<a href='/topic/show?id=eb615005c7' target=_blank style='color:#2F92EE;'>#Colorectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5005, encryptionId=eb615005c7, topicName=Colorectal)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465792, encodeId=53b31465e92ff, content=<a href='/topic/show?id=b5765443896' target=_blank style='color:#2F92EE;'>#手术方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54438, encryptionId=b5765443896, topicName=手术方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5506759018, createdName=yangcx0917, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1513313, encodeId=398c15133139e, content=<a href='/topic/show?id=6a446120454' target=_blank style='color:#2F92EE;'>#机器人辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61204, encryptionId=6a446120454, topicName=机器人辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=324410545094, createdName=124987a0m69(暂无昵称), createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1862044, encodeId=3f001862044c7, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Sat May 05 17:10:00 CST 2018, time=2018-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999148, encodeId=48ac199914898, content=<a href='/topic/show?id=70e1152462e' target=_blank style='color:#2F92EE;'>#Rectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15246, encryptionId=70e1152462e, topicName=Rectal)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f378286, 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objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Sun Nov 11 06:10:00 CST 2018, time=2018-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849568, encodeId=f6741849568ec, content=<a href='/topic/show?id=61815385aa' target=_blank style='color:#2F92EE;'>#CTA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5385, encryptionId=61815385aa, topicName=CTA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec9955, createdName=windight, createdTime=Thu Aug 16 12:10:00 CST 2018, time=2018-08-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276399, encodeId=b03b12e63993c, content=<a 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391751, encodeId=6eea1391e5192, content=<a href='/topic/show?id=eb615005c7' target=_blank style='color:#2F92EE;'>#Colorectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5005, encryptionId=eb615005c7, topicName=Colorectal)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1465792, encodeId=53b31465e92ff, content=<a href='/topic/show?id=b5765443896' target=_blank style='color:#2F92EE;'>#手术方法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54438, encryptionId=b5765443896, topicName=手术方法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5506759018, createdName=yangcx0917, createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1513313, encodeId=398c15133139e, content=<a href='/topic/show?id=6a446120454' target=_blank style='color:#2F92EE;'>#机器人辅助#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61204, encryptionId=6a446120454, topicName=机器人辅助)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=324410545094, createdName=124987a0m69(暂无昵称), createdTime=Wed Dec 06 02:10:00 CST 2017, time=2017-12-06, status=1, ipAttribution=)]
    2017-12-06 xue8602
  8. [GetPortalCommentsPageByObjectIdResponse(id=1862044, encodeId=3f001862044c7, content=<a href='/topic/show?id=a374102813a1' target=_blank style='color:#2F92EE;'>#高风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102813, encryptionId=a374102813a1, topicName=高风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Sat May 05 17:10:00 CST 2018, time=2018-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999148, encodeId=48ac199914898, content=<a href='/topic/show?id=70e1152462e' target=_blank style='color:#2F92EE;'>#Rectal#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15246, encryptionId=70e1152462e, topicName=Rectal)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f378286, 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  9. 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  10. 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