机器人与3D腹腔镜辅助直肠癌根治术近期疗效对比研究  

Comparison of short-term outcomes between robotic and 3D laparoscopic-assisted anterior resection of rectal cancer

作　　者：杜晓辉[1] 邹振玉[1] 李荣[1] 

机构地区：[1]解放军总医院普通外科,北京100853

出　　处：《腹部外科》2016年第3期205-208,共4页Journal of Abdominal Surgery

摘　　要：目的对比达芬奇机器人直肠癌根治术与3D腹腔镜直肠癌根治术的术后近期疗效和安全性。方法回顾性分析2009年6月至2015年10月间解放军总医院实施的达芬奇机器人直肠癌前切除术64例的临床资料。选择2014年6月至2015年10月间同中心同手术组实施的临床病理基线特征相似的3D腹腔镜直肠癌前切除术128例的临床资料作对比。结果达芬奇机器人组较3D腹腔镜组术中出血量明显减少[(53.75±12.28)ml比(77.97±59.21)ml,P=0.000],但手术时间较3D腹腔镜组延长[(205.44±110.60)min比(175.55±37.68)min,P=0.039]。两组术后肛门排气时间、恢复进食时间、留置导尿时间、淋巴结清扫数目、术后并发症、术后住院时间等方面差异均无统计学意义(P>0.05)。达芬奇机器人组的手术费用明显高于3D腹腔镜组[(9.44±1.33)万元比(6.86±1.18)万元,P=0.003]。结论 3D腹腔镜直肠癌前切除术是一项安全有效的新技术,与机器人手术相比,在推广应用方面具有明显优势。Objective To compare the short-term outcomes and security of anterior resection of rectal cancer between Da Vinci robotics surgical system and three-dimensional （3D） laparoscopy. Meth- otis The clinicopathological data from 64 rectal cancer patients who underwent robotic anterior resec- tion at Chinese PLA General Hospital from June 2009 to October 2015 were retrospectively analyzed. 128 patients undergoing 3D laparoscopic anterior resection of rectal cancer operated by the same sur- geons at Chinese PLA General Hospital from June 2014 to October 2015 and matched for the baseline of clinicopathological data with those subject to robotic anterior resection were selected. Results The blood loss was significantly less in the robotic group than in the 3D laparoscopic group （53. 75 ± 12. 28 vs. 77. 97 ± 59. 21 mL, P = 0. 000）. The operating time was longer in the robotic group than in the 3D laparoscopic group （205. 44 ± 110. 60 min vs. 175. 55 ± 37. 68 rain, P = 0. 039）. There were no signif- icant differences in the time of first flatus passage, the time of first diet, the time of removing the uri- nary catheter, the number of retrieved lymph nodes, the complications, and the length of hospital stay between two groups. In addition, the cost of surgery was significantly higher in robotic group than in 3D laparoscopic group （9. 44 ± 1.33 thousands Yuan RMB vs. 6. 86 ± 1.18 thousands Yuan RMB, P = 0. 003）. Conclusions 3D laparoscopic anterior resection of rectal cancer is safe and effective.

关 键 词：达芬奇机器人手术系统 腹腔镜 直肠肿瘤 预后 

分 类 号：R735.37[医药卫生—肿瘤]