达芬奇机器人手术与腹腔镜辅助胃癌根治术的对比研究  

A comparative study on Da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer

作　　者：刘兆礼 仲蓓[1] 赵资文 李大略 王冬[1] 王东升[1] Liu Zhaoli;Zhong Bei;Zhao Ziwen;Li Dalue;Wang Dong;Wang Dongsheng(Department of Gastrointestinal Surgery,Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院胃肠外科,山东省266003

出　　处：《中华普通外科杂志》2020年第2期100-103,共4页Chinese Journal of General Surgery

基　　金：青岛市市南区科技发展基金(2015-6-008-YY)。

摘　　要：目的对比分析达芬奇机器人与传统腹腔镜手术对胃癌患者近期临床结局的影响。方法回顾性分析2014年10月至2018年8月间青岛大学附属医院胃肠外科行达芬奇机器人手术108例和腹腔镜手术263例胃癌患者的临床资料。结果机器人组较腹腔镜组手术时间长[(269±32)min比(205±30)min,t=18.314,P<0.05],术中出血量少[(94±52)ml比(130±32)ml,t=-8.212,P<0.05],中转开腹率低(2.89%比8.7%,χ2=4.184,P<0.05),淋巴结清扫数目多[(45±11)枚比(41±10)枚,t=3.502,P<0.05],术后排气时间早[(59±8)h比(61±9)h,t=-2.396,P<0.05],总住院费用高[(75763±2981)元比(52746±3904)元,t=55.024,P<0.05],差异均有统计学意义;两组术后住院时间[(6.6±0.9)d比(6.5±1.1)d,t=0.618,P>0.05]、近端切缘距离[(5.7±1.1)cm比(5.4±1.2)cm,t=1.583,P>0.05]及远端切缘距离[(4.7±2.1)cm比(4.9±2.0)cm,t=0.848,P>0.05]相比差异均无统计学意义;两组术后并发症发生率(13.9%比15.2%,χ2=0.106,P>0.05)和术后Clavien-Dindo手术并发症分级(Z=-0.271,P>0.05)比较差异均无统计学意义。结论达芬奇机器人胃癌根治术是安全有效的,在清扫淋巴结、控制术中出血、降低中转开腹率及胃肠功能恢复方面较腹腔镜手术具有一定优势。Objective To compare the short-term surgical outcomes of robotic-assisted gastrectomy versus laparoscopic-assisted procedures for gastric cancer patients.Method From 2014 to 2018,108 robotic procedures and 263 laparoscopic surgery were done at Affiliated Hospital of Qingdao University.Results Compared with the laparoscopic group,the robotic group had longer operation time[(269±32)min vs.(205±30)min,t=18.314,P<0.05],less intraoperative blood loss[(94±52)ml vs.(130±32)ml,t=-8.212,P<0.05],lower conversion rate(χ2=4.184,P<0.05),more lymph node dissection[(45±11)vs.(41±10),t=3.502,P<0.05],earlier exhaust time[(59±8)h vs.(61±9)h,t=-2.396,P<0.05],higher total hospitalization cost[(75763±2981)yuan vs.(52746±3904)yuan,t=55.024,P<0.05].There were no significant differences in hospital stay[(6.6±0.9)d vs.(6.5±1.1)d,t=0.618,P>0.05],the proximal margin[(5.7±1.1)cm vs.(5.4±1.2)cm,t=1.583,P>0.05]and distal tumor margin[(4.7±2.1)cm vs.(4.9±2.0)cm,t=0.848,P>0.05];There were no significant differences in the incidence of complications(13.9%vs.15.2%,χ2=0.106,P>0.05)and grade by Clavien-Dindo operation complications(Z=-0.271,P>0.05)between the two groups.Conclusion Da Vinci robotic radical gastrectomy is safe,better than laparoscopic procedure in intraoperative manipulation.

关 键 词：胃肿瘤 机器人 腹腔镜 胃切除术 

分 类 号：R735[医药卫生—肿瘤]