达芬奇机器人与腹腔镜胃癌手术近期疗效的对照研究  

Surgical short-term outcomes of robotic gastrectomy versus laparoscopic gastrectomy:a case-control study

作　　者：刘驰[1] 唐波[1] 郝迎学[1] 石彦[1] 曾冬竹[1] 罗华星[1] 赵永亮[1] 钱锋[1] 余佩武[1] 

机构地区：[1]第三军医大学西南医院全军普通外科中心,微创外科中心,重庆400038

出　　处：《第三军医大学学报》2013年第11期1164-1166,共3页Journal of Third Military Medical University

基　　金：重庆市科技攻关计划(CSTC2012ggyyjs10029)~~

摘　　要：目的对比达芬奇机器人手术系统与腹腔镜手术治疗胃癌的临床近期疗效,以评估达芬奇机器人手术系统在治疗胃癌中的安全性及可行性。方法采用非随机对照设计,按照患者自愿的原则选择手术方式,分析2010年3月至2012年3月在本中心进行胃癌根治术患者的临床资料,其中使用达芬奇机器人手术系统进行胃癌根治术48例,以患者年龄、性别、BMI、肿瘤分期为协变量使用最邻配比法配对腹腔镜组手术患者48例。对比分析2组患者的手术指标、病例指标及术后短期疗效指标。2组患者手术均由同年资医师顺利完成。结果与腹腔镜组比较,达芬奇机器人手术组术中出血量更少[107.8±55.9)mLvs(132.7±61.5)mL,P=0.041],淋巴结清扫更彻底[(34.7±5.2)vs(32.5±4.7),P=0.026],但手术时间更长[(238.0±29.6)minvs(221.5±33.1)min,P=0.011]。结论对比腹腔镜手术系统治疗胃癌,达芬奇机器人手术系统术中对患者造成的损伤更小,肿瘤清扫更为彻底。因此,使用达芬奇机器人手术系统治疗胃癌安全、可行。Objective To compare the short-term surgical outcomes of robotic gastrectomy with laparoscopic gastrectomy for gastric cancer in order to evaluate the safety and feasibility of robotic surgery system. Methods Clinical data of 48 patients undergoing robotic gastrectomy in our department from March 2010 to March 2012 were collected, and 48 patients receiving laparoscopic gastrectomy during the same period served as control. There was no significant difference in the age, sex, BMI and cancer stage between the 2 groups. All surgery was performed successfully by qualified surgeons with same years of experience. The operative indexes and short-term outcomes were compared between the 2 groups. Results Compared with the laparoscopic groups, the robotic group had less intraoperative blood loss （107.8±55.9 vs 132.7±61.5 mL, P=0.041）, larger number of lymph node dissection （34.7±5.2 vs 32.5±4.7, P=0.026） and longer operation time （238.0±29.6 vs 221.5±33.1 min, P=0.011）. Conclusion Compared with conventional laparoscopic gastrectomy, robotic surgery system has less harm to the patients, with better resection of primary tumor, and more thorough dissection of lymph nodes. Thus, it is feasible and safe for gastric cancer.

关 键 词：胃癌 胃癌根治术 达芬奇机器人手术系统 腹腔镜 术中术后评估 

分 类 号：R197.39[医药卫生—卫生事业管理] R730.56[医药卫生—公共卫生与预防医学]