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Objective To compare the surgical outcomes of RAC versus LAC for the surgery of sigmoid-rectal cancer.Methods In this study,19 patients received robotic assisted colectomy (RAC)and 37 patients received laparoscopic assisted colectomy (LAC).Results The duration of surgery was longer in the RAC group (240 ± 76) min vs.(177 ± 74) min,t =3.006,P =0.004.The blood loss was less in the RAC group (67 ±40) vs.(153 ±151) ml,t =-2.422,P=0.019.The time to tolerate solid food was shorter in the RAC group (6.1 ±2.2)d vs.(7.4 ±4.4)d,t =-1.329,P =0.189 and the postoperative hospital stay was shorter in the RAC group (8.5 ± 2.6) d vs.(10.0 ± 3.6) d,t =-1.577,P =0.121.Mobidity and number of lymph nodes harvested were similar in both groups.7 cases were converted to open surgery in LAC group but none in RAC group.Conclusion Compared to laparoscopic surgery,Robotic-assisted colorectomy was safe and associated with less blood losses,lower conversion rate to open surgery and faster recovery of bowel function.
ABSTRACT
Introdução: o câncer colorretal (CCR) é um tumor maligno frequente do aparelho digestivo e, no Brasil, representa a quarta causa de óbito. A sobrevida dos portadores de CCR é influenciada por uma série de variáveis, destacando-se o estadiamento tumoral. A principal modalidade terapêutica com perspectiva de cura é a cirúrgica, tendo como tratamentos adjuvantes a quimioterapia e a radioterapia. Objetivo: avaliar a sobrevida, bem como a taxa de complicações anastomótica dos pacientes com CCR acompanhados entre janeiro de 2007 e janeiro de 2013. Métodos: foi realizado estudo descritivo - série de casos com 171 pacientes. A variável dependente foi o tempo de sobrevida do CCR e as independentes foram faixa etária, sexo, sítio anatômico do tumor, infiltração tumoral e metástaselinfonodal. Resultados: a sobrevida global dos pacientes com CCR no pós operatório em 12, 24 e 36 meses de acompanhamento foi, respectivamente, de: 83,21, 76,56 e 63,47%. Acometimento linfonodal e o grau de infiltração tumoral representaram as variáveis relacionadas a pior prognóstico. Os sítios tumorais mais comuns foram o reto alto e sigmoide (43,75%), seguido do reto médio (18,75%) e reto baixo (18,75%). A deiscência anastomótica foi a complicação pós-operatória mais frequente (6,43%). Conclusão: a infiltração tumoral na parede intestinal e o número de linfonodos positivos influenciaram negativamente o tempo de vida dos pacientes com CCR. A fístula compreendeu a principal complicação anastomótica pós-operatória.
Introduction: Colorectal cancer (CRC) is a common malignant tumor of digestive tract and, in Brazil, is the fourth leading cause of cancer. The survival of patients with CRC is influenced by a number of variables, especially the tumor staging. The main therapeutic modality with the prospect of cure is surgical, and as adjuvant chemotherapy and radiotherapy treatments. Objective: Evaluate survival, and the rate of anastomotic complications of patients with CCR followed between January 2007 and January 2013. Methods: This is a descriptive - series of cases study of 171 patients. The dependent variable was the survival time of the CCR and the independent variables were age, gender, anatomic site of the tumor, tumor infiltration and lymph node metastasis. Results: The overall survival of patients with CRC postoperatively in 12, 24 and 36 months follow-up, were respectively 83.21%, 76.56% and 63.47%. The presence of lymph node involvement and the degree of tumor infiltration accounted for variables related to worse prognosis. The most common tumor sites were the rectum and sigmoid high (43.75%), followed by the rectum (18.75%) and lower rectum (18.75%). The anastomotic leak was the most common postoperative (6.43%) complication. Conclusion: The tumor infiltration in the intestinal wall and the number of positive nodes influenced negatively on the survival of patients with RCC. The fistula understood the main postoperative anastomotic complication