机器人辅助腹腔镜与普通腹腔镜处理腹膜后肿瘤的疗效比较  

Comparison of clinical efficacy betwen robot-assisted laparoscopy and conventional laparoscopy in treatment of retroperitoneal tumors

作　　者：朱云鹏[1] 胡恒龙[1] 陈子琦[2] 卢宇超[1] 张加桥[1] 张宗彪[1] 秦保龙[1] 高鸿斌[1] 王宇锋[1] 朱建宁[1] 王庆[1] 寻阳[1] 徐璐[1] 王少刚[1] 

机构地区：[1]华中科技大学同济医院附属同济医院泌尿外科,武汉430030 [2]郑州大学基础医学院临床医学系

出　　处：《临床泌尿外科杂志》2017年第8期585-588,共4页Journal of Clinical Urology

摘　　要：目的:比较机器人辅助腹腔镜与普通腹腔镜处理腹膜后肿瘤的手术安全性和临床疗效。方法:回顾性分析2010年10月~2016年10月期间在我院接受腹腔镜手术治疗的腹膜后肿瘤患者的临床资料,其中接受机器人辅助腹腔镜手术的患者共计有20例,接受普通腹腔镜手术的患者共计有47例。收集统计所有患者临床资料,按照1∶1比例精确匹配20例接受普通腹腔镜腹膜后肿瘤切除术的患者组成对照组,主要匹配参数为患者的肿瘤良恶性、肿瘤大小以及肿瘤位置。比较两组患者基本特征、围手术期资料、术中与术后并发症发生情况及术后随访结果,并将两组患者合并一起,统计分析手术临床效果与肿瘤位置、肿瘤最大直径的相关性。结果:匹配性分析显示两组患者在性别构成(P=0.519)、年龄(P=0.110)、体质指数(P=0.360)、术前ASA评分(P=0.677)及肿瘤最大直径(P=0.660)等方面的差异均无统计学意义。手术安全性及手术疗效指标:手术转开放率(P=0.598)、手术时间(P=0.777)、术中出血量(P=0.450)、术后引流时间(P=0.508)、术后住院天数(P=0.375)、术中并发症(P=0.661)及Clavien评分(P=0.056)差异均无统计学意义。肿瘤位置与手术时间的相关系数r=0.331,有相关性(P=0.037);肿瘤位置与手术后住院天数的相关系数r=0.010,有相关性(P=0.010)。结论:腹膜后肿瘤的切除的难易程度与肿瘤的位置显著相关;机器人辅助腹腔镜下腹膜后肿瘤切除是安全、有效、可行的,与普通腹腔镜相比能达到相同的手术效果。Objective：To compare the safety and clinical efficacy between robot-assisted laparoscopy and conventional laparoscopy in the treatment of retroperitoneal tumors.Method：We retrospectively collected the clinical data of patients with retroperitoneal tumors treated by laparoscopic surgery.From October 2010 to October 2016 in our hospital,20 cases underwent robot-assisted laparoscopic surgery and 47 cases received conventional laparoscopic surgery.According to 1∶1 ratio,20 patients who received conventional laparoscopic surgery were matched by the pathology of tumor,the size of tumor and the location of tumor.The clinical data were analyzed including basic characteristics,perioperative data,complication and follow-up results.According to the location of tumor,two groups were divided into difficult parts.We statistically analyzed the correlation between surgical clinical outcomes and the location of tumor,the maximum diameter of tumor.Result：We analyzed the clinical data of the two groups.There was no significant difference between the two groups regarding the gender composition,age,BMI,the score of ASA,the maximum diameter of tumor.Also,the open conversion rate,the operation time,estimated blood loss,postoperative drainage duration,postoperative hospital stay,postoperative complications between the two groups showed no significant difference.However,there was significant correlation between the location of tumor and operation time,postoperative hospital stay.Conclusion：The difficulty of resecting retroperitoneal tumors is closely related to the location of tumor.Robot-assisted laparoscopic resection of retroperitoneal tumors is safe,effective and feasible and can achieve equal therapeutic efficacy compared with conventional laparoscopy.

关 键 词：机器人辅助腹腔镜 腹膜后肿瘤 普通腹腔镜 

分 类 号：R699.1[医药卫生—泌尿科学] R735.4[医药卫生—外科学]