Short‐term outcomes of robotic‐assisted surgery following neoadjuvant chemotherapy for lower rectal cancer
Short‐term outcomes of robotic‐assisted surgery following neoadjuvant chemotherapy for lower rectal cancer
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下位直肠癌新辅助化疗后机器人辅助手术的短期结果
DOI：
10.1111/ases.13055
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发表时间：
2022
影响因子：
1
通讯作者：
Hakamada Kenichi
中科院分区：
文献类型：
--
作者：
Morohashi Hajime;Sakamoto Yoshiyuki;Miura Takuya;Ichinohe Daichi;Kubota Shunsuke;Yamazaki Keisuke;Ichisawa Aika;Mitsuhashi Yuto;Wakiya Taiichi;Hakamada Kenichi
已有关于机器人手术联合放化疗（CRT）治疗直肠癌的报道，但只有少数研究比较了机器人手术联合和不联合新辅助化疗（NAC）的使用。我们研究的目的是比较机器人手术在有和没有NAC的情况下治疗低位直肠癌的围手术期结果，并检查NAC对机器人手术的影响。我们比较了45例未接受NAC治疗的患者和55例接受NAC治疗的患者的短期结果。非NAC组（P= .024）。NAC组的总手术时间明显长于非NAC组（P< .001）。NAC组的外侧淋巴结清扫率显著高于非NAC组（P< .001）。两组间切口手术部位感染（SSI）、器官/空间SSI术后出血、小肠梗阻、吻合口漏、泌尿功能障碍或泌尿系感染的发生率无显著差异。有8例发生侧方淋巴结转移（15%）和2例切除边缘阳性（4.0%）在NAC group. ConclusionsRoboticsurgery后NAC有并发症少，更高的保肛率没有NAC。
IntroductionThere have been reports about robotic surgery for rectal cancer with chemoradiotherapy (CRT), but only a few studies have compared the use of robotic surgery with and without neoadjuvant chemotherapy (NAC). The aim of our study was to compare the perioperative outcomes of robotic surgery with and without NAC for lower rectal cancer and to examine the effects of NAC on robotic surgery.MethodsFrom January 2016 to July 2021, we compared the short‐term outcomes of 45 patients who did not undergo NAC and 55 patients who underwent NAC.ResultsThe rate of sphincter‐preserving surgeries was higher in the NAC group than in the non‐NAC group (P= .024). The total operative time was significantly longer in the NAC group than in the non‐NAC group (P< .001). The rate of lateral lymph node dissection was significantly higher in the NAC group than in the non‐NAC group (P< .001). No significant differences were identified in the rate of incisional surgical site infections (SSI), organ/space SSI postoperative bleeding, small bowel obstruction, anastomotic leakage, urinary dysfunction, or urinary infections between the groups. There were eight incidences of lateral lymph node metastasis (15%) and two cases with positive resection margins (4.0%) in the NAC group.ConclusionsRobotic surgery after NAC has few complications and a higher sphincter‐preserving rate that without NAC.
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