Initial experience of laparoscopic complete mesocolic excision with D3 lymph node dissection for right colon cancer using Artisential(®), a new laparoscopic articulating instrument.
Initial experience of laparoscopic complete mesocolic excision with D3 lymph node dissection for right colon cancer using Artisential(®), a new laparoscopic articulating instrument.
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DOI：
10.4103/jmas.jmas_88_21
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发表时间：
2022-04
影响因子：
0.8
通讯作者：
Lee YS
中科院分区：
文献类型：
--
作者：
Jin HY;Ibahim AM;Bae JH;Lee CS;Han SR;Lee IK;Lee DS;Lee YS
腹腔镜全结肠系膜切除术(CME)加右半结肠D3淋巴清扫术正变得越来越流行，但在技术上仍具有挑战性。为了减少技术困难，已经引进了几种铰接式腹腔镜器械；然而，这些器械并不实用。本研究旨在报告一种新型的腹腔镜关节器械ArtiSential®在右半结肠癌腹腔镜全结肠系膜D3淋巴清扫术中的首次临床应用经验。这是一项回溯性的、单一机构、连续的案例研究。从2018年10月至2020年3月，共有33例患者使用新型关节器械ArtiSential®在腹腔镜下施行右半结肠切除术。我们比较了使用ArtiSential®(AG)和传统器械(CG)进行手术的患者的短期结果。AG组33例，CG组43例。两组在手术时间(141.0±22.5min比156.0±50.6min，P=0.09)、术中出血量(46.8±36.2ml比100.8±300.6 ml，P=0.31)、术中术后并发症等方面差异无统计学意义。但观察组的淋巴结清扫数明显多于对照组(32.6±12.2对24.6±7.4，P=0.01)，住院时间明显短于对照组(3.0±1.2对4.1±2.2天，P=0.01)。采用ArtiSential®进行右半结肠癌D3淋巴结清扫术的新型铰接式腹腔镜器械是安全和技术可行的。
Laparoscopic complete mesocolic excision (CME) with D3 lymph node dissection for the right colon is becoming popular, but still technically challenging. Several articulating laparoscopic instruments had been introduced to reduce technical difficulties; however, those were not practical. This study aimed to report the first clinical experience of using ArtiSential®, a new laparoscopic articulating instrument in laparoscopic complete mesocolic with D3 lymph node dissection for right colon cancer. This was a retrospective, single-institution, consecutive case study. From October 2018 to March 2020, a total of 33 patients underwent laparoscopic right hemicolectomy using ArtiSential® , a new articulating instrument. We compared the short-term outcomes of patients who underwent surgery using ArtiSential® (AG) to the conventional instrument (CG). In total, there were 33 cases in AG and 43 cases in CG. There were no significant differences in operation time (141.0 ± 22.5 vs. 156.0 ± 50.6 min, P = 0.09), mean estimated blood loss (46.8 ± 36.2 vs. 100.8 ± 300.6 ml, P = 0.31) and intra-operative and post-operative complications. However, the number of harvested lymph nodes was higher and the length of hospital stay was shorter in AG than in CG (32.6 ± 12.2 vs. 24.6 ± 7.4, P < 0.01 and 3.0 ± 1.2 vs. 4.1 ± 2.2 days, P = 0.01, respectively). Laparoscopic CME with D3 lymph node dissection for right colon cancer using ArtiSential®, the new articulating laparoscopic instrument is safe and technically feasible.