Background and Objective: Colorectal cancer (CRC) is the third most common cancer worldwide, with colon cancer accounting for approximately 60% of all CRC cases. Surgery remains the primary and most effective treatment. Robotic-assisted surgery (RAS) has emerged as a promising approach for colon cancer resection. This retrospective study compares RAS and laparoscopic-assisted surgery (LSS) for stage I–III colon cancer resections at a single medical center in East Asia.Methods: Between 1 January 2018, and 29 February 2024, patients undergoing colectomy were classified into right-side and left-side colectomies. Propensity score matching was conducted based on age group, gender, ASA score, and BMI to ensure comparability between groups. After matching, there were 50 RAS and 200 LSS cases for right colectomy (RC), and 129 RAS and 258 LSS cases for left colectomy (LC). Perioperative outcomes were compared between the two surgical approaches. The primary outcomes were recovery milestones, while secondary outcomes included complications and postoperative pain scores.Results: RAS demonstrated faster recovery milestones compared to LSS (hospital stay: 6.5 vs. 10.2 days,p= 0.005 for RC; 5.5 vs. 8.2 days,p< 0.001 for LC). RAS also resulted in lower rates of ileus (14% vs. 26%,p= 0.064 for RC; 6.2% vs. 15.9%,p= 0.007 for LC) and higher lymph node yields (31.4 vs. 26.8,p= 0.028 for RC; 25.8 vs. 23.9,p= 0.066 for LC). Major complication rates showed no significant difference between RAS and LSS (4.0% vs. 7.0%,p= 0.746 for RC; 4.7% vs. 3.1%,p= 0.563 for LC). Patients in the RAS group experienced earlier diuretic phases and reported significantly lower postoperative pain scores (3.0 vs. 4.1,p= 0.011 for RC; 2.9 vs. 4.1,p< 0.001 for LC).Conclusions: Robotic-assisted surgery is associated with faster recovery, lower rates of ileus (LC), higher lymph node yield (RC) and reduced postoperative pain compared to laparoscopic-assisted surgery for colon cancer resection.
背景与目的：结直肠癌是全球第三大常见癌症，其中结肠癌约占所有结直肠癌病例的60%。手术仍是结肠癌最主要且最有效的治疗方式。机器人辅助手术已成为结肠癌切除的一种前景广阔的技术。本回顾性研究旨在比较东亚某单一医疗中心对Ⅰ-Ⅲ期结肠癌患者行机器人辅助手术与腹腔镜辅助手术的疗效差异。 方法：研究纳入2018年1月1日至2024年2月29日期间接受结肠切除术的患者，根据手术部位分为右半结肠切除术与左半结肠切除术两组。通过倾向评分匹配法，依据年龄组、性别、美国麻醉医师协会评分及体重指数进行配对，确保组间可比性。匹配后右半结肠切除术组包含50例机器人辅助手术与200例腹腔镜辅助手术病例，左半结肠切除术组包含129例机器人辅助手术与258例腹腔镜辅助手术病例。比较两种手术方式的围手术期结局，主要观察指标为术后恢复里程碑事件，次要指标包括并发症发生率及术后疼痛评分。 结果：与腹腔镜辅助手术相比，机器人辅助手术组患者恢复更快（右半结肠切除术：住院时间6.5天 vs. 10.2天，p=0.005；左半结肠切除术：5.5天 vs. 8.2天，p<0.001）。机器人辅助手术组肠梗阻发生率更低（右半结肠切除术：14% vs. 26%，p=0.064；左半结肠切除术：6.2% vs. 15.9%，p=0.007），淋巴结获取数量更多（右半结肠切除术：31.4枚 vs. 26.8枚，p=0.028；左半结肠切除术：25.8枚 vs. 23.9枚，p=0.066）。两组主要并发症发生率无显著差异（右半结肠切除术：4.0% vs. 7.0%，p=0.746；左半结肠切除术：4.7% vs. 3.1%，p=0.563）。机器人辅助手术组患者更早进入多尿期，且术后疼痛评分显著更低（右半结肠切除术：3.0分 vs. 4.1分，p=0.011；左半结肠切除术：2.9分 vs. 4.1分，p<0.001）。 结论：在结肠癌切除术中，与腹腔镜辅助手术相比，机器人辅助手术具有恢复更快、肠梗阻发生率更低（左半结肠切除术）、淋巴结获取数量更多（右半结肠切除术）及术后疼痛更轻的优势。
肿瘤(癌症)患者之家