机器人与腹腔镜在低位直肠癌经括约肌间切除术的近期疗效对比

目的比较机器人和腹腔镜在低位直肠癌经括约肌间切除术的近期疗效，探讨机器人经括约肌间切除术的安全性及可行性。 方法回顾性分析2015年10月至2017年10月甘肃省人民医院肛肠科确诊为低位直肠癌并行机器人或者腹腔镜经括约肌间切除患者的人口及临床资料。收集并比较两组的手术时间、术中出血量、中转开腹率、首次通气时间、术后住院时间、并发症、肿瘤距远切缘的距离、环周切缘的阳性数、清扫淋巴结数量等。 结果机器人组流质饮食时间、首次通气时间、术后住院时间较腹腔镜组短（均P<0.05）；机器人组术中失血量多于腹腔镜组（P<0.05）；机器人与腹腔镜组在手术时间上差异无统计学意义，两组的术后并发症的差异无统计学意义，机器人组的总费用高于腹腔镜组（P<0.001）。 结论机器人低位直肠癌经括约肌间切除术是安全、可行的。与腹腔镜组手术相比，机器人组术后肠功能恢复快，住院时间短，近期肿瘤学的结果安全可靠，可作为低位直肠癌治疗的有效手段之一。

Comparison of short-term outcomes between robot-assisted versus laparoscopic intersphincteric resection for low rectal cancer

ObjectiveTo compare the short-term efficacy of robotic and laparoscopic sphincterotomy for low rectal cancer and to investigate the safety and feasibility of robotic sphincterotomy. MethodsThe characteristics of patients underwent robot-assisted or laparoscopic intersphincteric resection for low rectal cancer were retrospectively collected from October 2015 to October 2017 in Gansu Provincial Hospital. Compared the operative time, intraoperative blood loss, intraoperative laparotomy, first ventilation time, postoperative hospital stays, complications, distance from the distant margin of the tumor, number of positive circumferential resection margins, number of lymph nodes removed, and other outcoms between two groups. ResultsThe liquid diet time, first ventilation time and postoperative hospital stays of the robot group were shorter than the laparoscopic group (P<0.05). The intraoperative blood loss in the robot group was more than the laparoscopic group (P<0.05). There were no significant difference between two groups in postoperative complications or operation time. The total cost of the robotic group was higher than the laparoscopic group (P<0.001). ConclusionsRobotic sphincterotomy for low rectal cancer is safe and feasible. Compared with laparoscopic surgery, the robotic surgery had rapider recovery of bowel function, shorter hospital stays, and more reliable short-term efficacy in oncology. Robotic sphincterotomy may be an effective treatment for the low rectal cancer.