机器人手术治疗子宫内膜癌合并肥胖  

Robotic Surgery in the Treatment of Endometrial Cancer with Obesity

作　　者：龚静[1] 王楠[2] 王敏[2] 温娜[2] 边立华[2] 叶明侠[2] 孟元光[2] 

机构地区：[1]首都医科大学附属北京安贞医院妇产科,北京100029 [2]解放军总医院妇产科,北京100853

出　　处：《中国微创外科杂志》2016年第8期685-688,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨达芬奇机器人手术治疗子宫内膜癌合并肥胖患者（BMI≥28）的可行性和安全性。方法选取2013年1月-2015年12月73例子宫内膜癌,其中27例BMI≥28行机器人手术（机器人组）,46例BMI〈28行腹腔镜手术（腹腔镜组）,比较2组术中、术后情况。结果 2组手术时间[（239.4±40.7）min vs.（233.0±52.5）min,t=0.544,P=0.588]、术中出血量[（136.1±85.0）ml vs.（121.7±76.3）ml,t=0.746,P=0.458]、盆腔淋巴结切除数[（23.1±9.8）枚vs.（20.9±12.0）枚,t=0.807,P=0.422]、腹主动脉旁淋巴结切除数[（2.1±1.3）枚vs.（2.3±1.7）枚,t=-0.527,P=0.600]、总淋巴结切除数[（24.4±11.1）枚vs.（22.4±13.5）枚,t=0.651,P=0.517]和术中输血率[18.5%（5/27）vs.19.6%（9/46）,χ^2=0.012,P=0.913]均无统计学差异。2组术后早期[18.5%（5/27）vs.19.6%（9/46）,χ^2=0.012,P=0.913]、晚期并发症发生率[3.7%（1/27）vs.4.3%（2/46）,χ^2=0.000,P=1.000]和住院时间[（19.8±6.3）d vs.（18.7±6.2）d,t=0.727,P=0.469]无统计学差异。结论达芬奇机器人手术系统行子宫内膜癌分期手术治疗子宫内膜癌合并肥胖安全、可行。Objective To evaluate the feasibility and safety of robotic surgery for endometrial cancer complicated with obesity（ BMI ≥ 28）. Methods A total of 73 patients with endometrial cancer enrolled in Chinese PLA General Hospital during the period from January 2013 to December 2015 were identified. They were divided into either observation group（ BMI≥28,n = 27） performed by robotic surgery or control group（ BMI 28,n = 46） performed by traditional laparoscopic surgery. The clinical features,intraoperative and postoperative parameters of the two groups were compared. Results No significant differences were detected between the two groups in the operation time [（ 239. 4 ± 40. 7） min vs.（ 233. 0 ± 52. 5） min,t = 0. 544,P = 0. 588 ],bleeding volume [（ 136. 1 ± 85. 0） ml vs.（ 121. 7 ± 76. 3） ml,t = 0. 746,P = 0. 458],pelvic lymph node resection（ 23. 1 ± 9. 8 vs. 20. 9 ±12. 0,t = 0. 807,P = 0. 422）,para-aortic lymph node resection（ 2. 1 ± 1. 3 vs. 2. 3 ± 1. 7,t =- 0. 527,P = 0. 600）,total lymph node resection（ 24. 4 ± 11. 1 vs. 22. 4 ± 13. 5,t = 0. 651,P = 0. 517）,and intraoperative blood transfusion rate [18. 5%（ 5 /27） vs.19. 6%（ 9 /46）,χ^2= 0. 012,P = 0. 913]. There were no statistically significant differences between the two groups in terms of the rate of early postoperative complications [18. 5%（ 5 /27） vs. 19. 6%（ 9 /46）,χ^2= 0. 012,P = 0. 913] and late postoperative complication rate [3. 7%（ 1 /27） vs. 4. 3%（ 2 /46）,χ^2= 0. 000,P = 1. 000],as well as the hospitalization days [（ 19. 8 ± 6. 3） d vs.（ 18. 7 ± 6. 2） d,t = 0. 727,P = 0. 469]. Conclusion As compared with traditional laparoscopic surgery,the da Vinci robotic surgery system is safe and reliable and can overcome some of the challenges posed by the use of laparoscopy in endometrial cancer patients with obesity.

关 键 词：达芬奇机器人 腹腔镜 子宫内膜癌 肥胖 子宫内膜癌分期术 

分 类 号：R737.33[医药卫生—肿瘤] R589.2[医药卫生—临床医学]