改道结肠造口术随后进行新辅助治疗是梗阻性直肠癌的首选治疗方法。此类患者可以通过机器人方法进行治疗，与传统的腹腔镜手术相比，该方法具有多个优点。相反，现有造口可能会干扰最佳套管针位置，从而影响机器人手术的质量。而且操作台外科医生不面对患者，可能危及造口。 对在我院接受新辅助治疗后接受保肛手术的直肠癌患者，利用机器人平台进行回顾性调查。根据治疗前造口的情况，将患者分为NS组（无造口患者）和S组（有造口患者）。比较各组之间的基线特征、新辅助治疗类型、短期手术结果、术后肛门直肠测压数据和生存率。NS 组和 S 组分别包括 65 名患者和 9 名患者。 NS 组中的 3 名患者需要转为剖腹手术。 S 组比 NS 组需要更长的控制台时间（中位数分别为 367 分钟和 253 分钟，p = 0.038）；然而，总手术时间（p = 0.15）和失血量（p = 0.70）没有观察到差异。两组之间的术后并发症发生率、肛门直肠功能和肿瘤学结果相似。尽管有造口患者的控制台时间较长，但在新辅助治疗后可以像无造口患者一样安全地进行机器人手术。© 2024。作者）。

Diverting colostomy followed by neoadjuvant treatment is a treatment of choice for obstructive rectal cancer. Such patients may be treated via a robotic approach with several advantages over conventional laparoscopic surgery. Conversely, the existing stoma may interfere with the optimal trocar position and thus affect the quality of robotic surgery. Moreover, the console surgeon does not face the patient, which may endanger the stoma.Patients with rectal cancer who underwent sphincter-preserving surgery were retrospectively investigated using a robotic platform after neoadjuvant treatment at our hospital. Based on pretreatment stoma creation, patients were divided into the NS (those without a stoma) and S groups (patients with a stoma). Baseline characteristics, types of neoadjuvant treatment, short-term surgical outcomes, postoperative anorectal manometric data, and survival were compared between the groups.The NS and S groups comprised 65 and 9 patients, respectively. Conversion to laparotomy was required in three patients in the NS group. The S group required a longer console time than the NS group (median: 367 vs. 253 min, respectively, p = 0.038); however, no difference was observed in the total operative time (p = 0.15) and blood loss (p = 0.70). Postoperative complication rates, anorectal function, and oncological outcomes were similar between the groups.Although console time was longer in patients with a stoma, robotic surgery could be performed safely like in those without a stoma after neoadjuvant treatment.© 2024. The Author(s).