Robotic versus laparoscopic left colectomy with complete mesocolic excision for left-sided colon cancer: a multicentre study with propensity score matching analysis

作者全名："Zheng, Huichao; Wang, Quan; Fu, Tao; Wei, Zhengqiang; Ye, Jingwang; Huang, Bin; Li, Chunxue; Liu, Baohua; Zhang, Anping; Li, Fan; Gao, Feng; Tong, Weidong"

作者地址："[Zheng, Huichao; Huang, Bin; Li, Chunxue; Liu, Baohua; Zhang, Anping; Li, Fan; Tong, Weidong] Army Med Univ, Daping Hosp, Army Med Ctr, Dept Gen Surg,Gastr & Colorectal Surg Div, Chongqing, Peoples R China; [Wang, Quan] First Hosp Jilin Univ, Dept Gastrocolorectal Surg, Changchun, Peoples R China; [Fu, Tao] Wuhan Univ, Dept Gastrointestinal Surg 2, Renmin Hosp, Wuhan, Peoples R China; [Wei, Zhengqiang] Chongqing Med Univ, Dept Gastrointestinal Surg, Affiliated Hosp 1, Chongqing, Peoples R China; [Ye, Jingwang] Peoples Hosp Shapingba Dist, Dept Gastrointestinal Surg, Chongqing, Peoples R China; [Gao, Feng] 940th Hosp Joint Logist Support Force PLA, Dept Colorectal Surg, Lanzhou, Peoples R China"

通信作者："Li, F; Tong, WD (通讯作者)，Army Med Univ, Daping Hosp, Army Med Ctr, Dept Gen Surg,Gastr & Colorectal Surg Div, Chongqing, Peoples R China.; Gao, F (通讯作者)，940th Hosp Joint Logist Support Force PLA, Dept Colorectal Surg, Lanzhou, Peoples R China."

来源：TECHNIQUES IN COLOPROCTOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000962651100001

JCR分区：Q1

影响因子：2.7

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Robotic left colectomy; Laparoscopic; Left-sided colon cancer; Complete mesocolic excision

摘要："PurposeRobotic surgery for right-sided colon and rectal cancer has rapidly increased; however, there is limited evidence in the literature of advantages of robotic left colectomy (RLC) for left-sided colon cancer. The purpose of this study was to compare the outcomes of RLC versus laparoscopic left colectomy (LLC) with complete mesocolic excision (CME) for left-sided colon cancer.MethodsPatients who had RLC or LLC with CME for left-sided colon cancer at five hospitals in China between January 2014 and April 2022 were included. A one-to-one propensity score matched analysis was performed to decrease confounding. The primary outcome was postoperative complications occurring within 30 days of surgery. Secondary outcomes were disease-free survival, overall survival and the number of harvested lymph nodes.ResultsA total of 292 patients (187 male; median age 61.0 [20.0-85.0] years) were eligible for this study, and propensity score matching yielded 102 patients in each group. The clinicopathological characteristics were well-matched between groups. The two groups did not differ in estimated blood loss, conversion to open rate, time to first flatus, reoperation rate, or postoperative length of hospital stay (p > 0.05). RLC was associated with a longer operation time (192.9 +/- 53.2 vs. 168.9 +/- 52.8 min, p = 0.001). The incidence of postoperative complications did not differ between the RLC and LLC groups (18.6% vs. 17.6%, p = 0.856). The total number of lymph nodes harvested in the RLC group was higher than that in the LLC group (15.7 +/- 8.3 vs. 12.1 +/- 5.9, p < 0.001). There were no significant differences in 3-year and 5-year overall survival or 3-year and 5-year disease-free survival.ConclusionCompared to laparoscopic surgery, RLC with CME for left-sided colon cancer was found to be associated with higher numbers of lymph nodes harvested and similar postoperative complications and long-term survival outcomes."

基金机构：Municipal Natural Science Foundation of Chongqing [cstc2021jcyj-msxmX0477]; National Clinical Key Specialty Construction Projects [4246ZA5]; clinical innovation project of Army Medical University [2019CXLCB004]

基金资助正文："AcknowledgementsWe thank surgeons Yue Tian, Yu Gao, Zhengyong Liu, Haode Shen, Guodong Xiao, Zhigang Ke, and Xiangfeng Wang and scrub nurses Feifei Huang and Liyuan Yao for great teamwork in the operating room. This study was supported by the Municipal Natural Science Foundation of Chongqing (cstc2021jcyj-msxmX0477), a grant from the National Clinical Key Specialty Construction Projects (4246ZA5), and a clinical innovation project of Army Medical University (2019CXLCB004)."