中国现代手术学杂志2026，Vol.30Issue(2)：107-113,7.DOI:10.16260/j.cnki.1009-2188.2026.02.004
梗阻性直肠癌缓解后一期行机器人与腹腔镜根治性切除的疗效分析
Efficacy analysis of robotic versus laparoscopic radical resection in one-stage surgery for obstructive rectal cancer after decompression
摘要
Abstract
Objective To compare the efficacy of robotic versus laparoscopic radical resection in one-stage surgery for obstructive rectal cancer after decompression.Methods A retrospective analysis was conducted on the clinical data of 41 patients with obstructive rectal cancer who underwent one-stage radical ante-rior resection at our hospital between January 2018 and December 2022.All patients received preoperative stent or decompression tube placement to relieve the obstruction.They were divided into a robotic group(n=19)and a laparoscopic group(n=22)based on the surgical approach.Perioperative outcomes,complications,and short-term prognosis were compared between the two groups.Results No conversions to open surgery occurred in either group.Compared with the laparoscopic group,the robotic group showed significantly less intraoperative blood loss[20(5,50)mL vs.44(40,52)mL,P=0.012],a higher rate of reinforcement suturing of the anastomosis(78.9%vs.27.3%,P=0.001),a lower rate of protective ileostomy(5.3%vs.31.8%,P=0.046),lower postoperative day 1 CRP levels[(24.1±14.1)mg/L vs.(41.3±21.7)mg/L,P=0.005],and a shorter postoperative hospital stay[(10.3±1.7)d vs.(11.4±1.6)d,P=0.040];however,the total operative time was longer in the robotic group[(188.4±15.5)min vs.(174.5±9.7)min,P=0.001].There were no sig-nificant differences between the two groups in terms of rates of left colonic artery preservation,pelvic peritoneum closure,and positive circumferential resection margin,distal resection margin distance,number of harvested lymph nodes,time to first flatus,catheter removal time,duration of anal tube placement,time to first liquid diet,and complication rates(all P>0.05).All patients were followed up,with a median follow-up time of 38 months(range,25-58 months).No significant differences were observed in local recurrence rates,distant metastasis rates,or 2-year overall survival between the two groups(all P>0.05).Conclusions In elective radical resection for obstructive rectal cancer after decompression,robotic surgery is associated with less blood loss,a lower rate of protective ileostomy,and a shorter hospital stay compared to laparoscopic surgery,without increasing complication risks,albeit with a longer operative time.Short-term oncological outcomes were similar between the two groups.关键词
直肠肿瘤/肠梗阻/机器人手术/腹腔镜手术/根治性切除术/一期手术Key words
rectal neoplasms/bowel obstruction/robotic surgery/laparoscopy/radical resection/one-stage surgery引用本文复制引用
张云,龚航军,韩刚,曹羽,张言言,张旭,胡建..梗阻性直肠癌缓解后一期行机器人与腹腔镜根治性切除的疗效分析[J].中国现代手术学杂志,2026,30(2):107-113,7.基金项目
中国医药卫生事业发展基金会医药科研课题项目(chmdf2024-xrzx02-14) （chmdf2024-xrzx02-14）
