Oncological Outcomes, Perioperative Outcomes
Conditions
Keywords
Robot, Right hemicolectomy, Complete mesocolic excision
Brief summary
the investigators performed a retrospective multicenter propensity score matching study. From July 2016 to July 2021, 382 consecutive patients from different Chinese surgical departments were available for inclusion out of an initial cohort of 412, who underwent robotic or laparoscopic right hemicolectomy with CME.
Detailed description
All consecutive patients who underwent robotic or laparoscopic right hemicolectomy with CME from July 2016 to July 2021 at three Chinese surgical departments (Department of General Surgery, Army Medical Center, Chongqing;Department of Colorectum, Chongqing University Three Gorges Hospital, Chongqing;Department of Colorectum, the 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou) were included in the study. A retrospective review of multicenter institutional database was conducted. The Da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) has been employed since 2016 in three centers. From July 2016 to July 2021, an initial cohort of 412 consecutive patients underwent robotic or laparoscopic right hemicolectomy with CME in three departments. With 30 cases meeting the exclusion criteria, 382 cases, including 204 males and 178 females, were available for inclusion. Of these, 149 cases by robotic right hemicolectomy with CME were classified as the robotic group, while the other 233 cases by laparoscopic right hemicolectomy with CME as the laparoscopic group.
Interventions
PROCEDURErobotic right hemicolectomy with CME
The distribution of trocars was placed according to the position of Intuitive Surgical Inc. for robotic colectomy. The robot was set to come and dock from theright shoulder of the patient. Three robotic 8-mm trocars (R1, R2 and R3) and two 12-mm trocars (camera and assistant port) were used for the robotic procedure. One working arm carrying a monopolar cautery hook for dissection was located in the left upper quadrant port (R1). The other two working arms carried bipolar forceps in the suprapubic port (R3), and Cadiere's fenestrated forceps in the right lower quadrant port (R2) that was used to keep the superior mesenteric axis in traction. After gentle cephalad traction on the transversemesocolon with the grasp in R2, the assistant grasped the ileocecal valve through the assistant port to put the ileocolic vascular pedicle on tension and the ileocolic vessels were identified and lifted up with R3.
Sponsors
Third Military Medical University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Adenocarcinoma was confirmed by preoperative colonoscopy and it was located in the right colon. 2. Preoperative enhanced abdominal CT examination showed no invasion of abdominal wall or adjacent organs. 3. The patient underwent robotic or laparoscopic right hemicolectomy with CME.
Exclusion criteria
1. Multiple primary colorectal tumors 2. Metastasis to abdominal 3. Pelvic or distant organs 4. Accompanied with bowel obstruction or perforation 5. Neuroendocrine tumors 6. Lymphomas 7. Other malignant tumors.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| diseasefree survival(months) | until July 2021 | Collect outcomes of follow-up and use Kaplan-Meier survival analysis to analyze it. |
| overall survival(months) | until July 2021 | Collect outcomes of follow-up and use Kaplan-Meier survival analysis to analyze it. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| estimated blood loss | during the surgery | the mililiter of the blood loss during surgery |
| oral retake | up to 30 days after surgery | the patients begin to recover intake |
| time to return to bowel function | up to 30 days after surgery | the patients begin to recover bowel function |
| length of stay | up to 30 days after surgery | the days of hospital stay |
| conversion rates | during the surgery | the incidence of a conversion to open surgery |
| complications | up to 30 days after surgery | Postoperative complications, such as ileus, anastomotic leak, small intestinal obstruction, bleeding and so on. Number of Participants with complications will be recorded. |
| harvest lymph nodes | up to 7 days after surgery | the number of harvest lymph nodes in postoperative pathological report |
| lymph node metastasis | up to 7 days after surgery | the number of patients with lymph node metastasis |
| total hospitalization cost | up to 30 days after surgery | the total cost of this treatment by RMB |
| operative time | during the surgery | the miniutes of surgery from skin to skin |
Countries
China
Outcome results
None listed