One year follow-up of the colon cancer patient cohort treated with a novel miniaturized robotic-assisted surgery device (mRASD)

John H. Marks, Michael A. Jobst, Deborah S. Keller, Jorge A. Lagares-Garcia, Henry P. Schoonyoung, Shane M. Farritor, Dmitry Oleynikov
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Abstract

Background

With the proven benefits of minimally invasive surgery, there is steady growth in robotic surgery use and interest in novel robotic platforms. A miniaturized Robotic-Assisted Surgery Device (mRASD) has been in clinical use under a multi-center, investigational device exemption (IDE) study for right and left colectomy. The goal of this work was to report the short-term and 12-month outcomes specifically for the cohort of colon cancer patients that underwent surgery using the mRASD.

Method

From the IDE study that included both benign and malignant diseases, long-term follow-up was only conducted for patients with colon cancer. The main outcome measures were the oncologic quality metrics (Overall Survival, OS and Disease-free Survival, DFS). Secondary outcomes included incidence of intra-operative, device-related, and procedure-related adverse events. Frequency statistics were performed to assess the measures of central tendency and variability in short (within 30 days) and long-term (1-year) outcomes.

Results

Thirty total patients underwent a colectomy with mRASD; 17 (57%) were diagnosed with a malignancy and included in this analysis. The mean patient age was 59.9 ± 13.2 years. There were no intraoperative or device-related adverse events. In 100% of cases (n = 17), the primary dissection was completed and hemostasis maintained using the mRASD, and negative margins were achieved. At 30 days postoperatively, the major complication rate was 6%, and there was one unplanned reoperation for anastomotic leak. At one-year follow-up, the OS and DFS rates were 100 and 94%, respectively. In one patient, omental implants were discovered at the time of surgery, and the patient opted to not undergo additional therapy.

Conclusions

The first experience with mRASD for colectomy in colon cancer demonstrated technical effectiveness and an acceptable surgical safety profile in line with other minimally invasive procedures. The study continues to monitor disease recurrence and survival outcomes in this cohort.

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对使用新型微型机器人辅助手术装置(mRASD)治疗的结肠癌患者进行为期一年的随访
背景随着微创手术的优势得到证实,机器人手术的使用稳步增长,人们对新型机器人平台的兴趣也日益浓厚。微型机器人辅助手术设备(mRASD)已在一项多中心、研究设备豁免(IDE)研究中用于左右结肠切除术的临床应用。这项工作的目的是报告使用 mRASD 进行手术的结肠癌患者的短期和 12 个月疗效。主要结果指标为肿瘤学质量指标(总生存期(OS)和无病生存期(DFS))。次要结果包括术中、设备相关和手术相关不良事件的发生率。对短期(30 天内)和长期(1 年)结果的中心倾向性和变异性进行了频数统计。患者平均年龄为(59.9 ± 13.2)岁。术中未发生与设备相关的不良事件。在100%的病例(n = 17)中,使用mRASD完成了初步剥离并保持了止血,而且达到了阴性边缘。术后30天,主要并发症发生率为6%,有1例因吻合口漏意外再次手术。随访一年后,OS 和 DFS 率分别为 100% 和 94%。结论mRASD用于结肠癌结肠切除术的首次经验表明,其技术有效性和可接受的手术安全性与其他微创手术一致。该研究将继续监测该组患者的疾病复发和生存情况。
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