机器人与腹腔镜辅助下低位直肠腺癌根治术应用效果对比  

Comparison of robotic and laparoscopic radical surgery in the treatment of low rectal adenocarcinoma

作　　者：杨康康 孙海峰 王时俊[1] 谷晓明[1] 王福奇[1] 袁维堂[1] YANG Kangkang;SUN Haifeng;WANG Shijun;GU Xiaoming;WANG Fuqi;YUAN Weitang(Department of Colorectal and Anal Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院结直肠肛门外科

出　　处：《郑州大学学报（医学版）》2020年第1期21-24,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省科技发展计划项目(142102310353)

摘　　要：目的:对比分析机器人与腹腔镜辅助下低位直肠腺癌根治术的应用效果。方法:104例低位直肠腺癌(肿瘤下缘距离肛缘≤5 cm)患者,53例行机器人辅助根治性切除术(机器人组),51例行腹腔镜辅助根治性切除术(腹腔镜组)。比较两组的根治性、安全性以及保肛率。结果:两组患者基线资料和临床病理特征的差异无统计学意义(P均>0.05)。所有患者均顺利完成手术,两组术后环周切缘均阴性。机器人组手术时间(283.06±63.99)min,保肛率达58.5%,首次排气时间(2.42±0.98)d,住院时间(14.47±3.79)d;腹腔镜组分别为(248.94±49.19)min、37.3%、(2.83±0.95)d、(19.37±5.26)d,机器人组手术时间更长,但保肛率高,首次排气时间和住院时间缩短(P均<0.05)。机器人组和腹腔镜组清扫淋巴结数分别为(14.11±5.91)和(11.98±5.64)枚,尿管拔除时间分别为(11.15±3.62)和(11.16±2.65)d,术后并发症发生率分别为5.7%和11.8%,差异均无统计学意义(P均>0.05)。结论:机器人手术具有保肛概率高,术后恢复快的优点。Aim:To compare the clinical application of robotic and laparoscopic assisted radical surgery for low rectal adenocarcinoma.Methods:Out of 104 patients with low rectal adenocarcinoma(the lower edge of the tumor from the anal margin≤5 cm),53 cases underwent robotic radical resection(robotic surgery group),and 51 cases underwent laparoscopic radical resection(laparoscopic surgery group).The curativeness,safety and anal retention rate of the two groups were compared.Results:There were no significant differences in baseline data and clinicopathological features between the two groups(P>0.05).Operations were successfully performed,and negative circumferential resection margins were achieved in all patients.The operation time of robotic surgery group[(283.06±63.99)min]was higher than that[(248.94±49.19)min]of laparoscopic surgery group(P<0.05).The anal retention rate was 58.5%,the first postoperative exhaust time was(2.42±0.98)d,hospitalization time was(14.47±3.79)d of robotic surgery group,those were 37.3%,(2.83±0.95)d and(19.37±5.26)d in the laparoscopic surgery group,and there were significant differences between the two groups(P<0.05).The number of dissected Lymph nodes was(14.11±5.91)in robotic surgery group and(11.98±5.64)in the laparoscopic surgery group,urinary catheter removal time was(11.15±3.62)d and(11.16±2.65)d,respectively,the incidence of postoperative complications was 5.7%and 11.8%,respectively;and the differences in the above indexes between the two groups were not significant(P>0.05).Conclusion:Robotic surgery has the advantages of high probability of maintaining anal sphincter and fast postoperative recovery.

关 键 词：机器人手术 腹腔镜手术 低位直肠腺癌 结直肠癌根治术 

分 类 号：R735.3[医药卫生—肿瘤]