达芬奇机器人系统辅助腹腔镜骶骨阴道固定术治疗盆腔器官脱垂的效果  

Effect of da Vinci Robotic-Assisted Laparoscopic Sacrocolpopexy in the Treatment of Pelvic Organ Prolapse

作　　者：张警方 纪妹[1] 苑中甫[1] 赵曌[1] 李悦[1] 许鹏琳 ZHANG Jing-fang;JI Mei;YUAN Zhong-fu;ZHAO Zhao;LI Yue;XU Peng-lin(Department of Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院妇科,河南郑州450052

出　　处：《河南医学研究》2020年第16期2895-2899,共5页Henan Medical Research

基　　金：河南省科技厅科技攻关项目(172102310057)。

摘　　要：目的探讨达芬奇机器人系统辅助腹腔镜骶骨阴道固定术治疗盆腔器官脱垂(POP)的效果。方法回顾性分析2016年1月至2018年12月郑州大学第一附属医院收治的98例POP(子宫及残端脱垂)患者的临床资料。按治疗方式分为腹腔镜组(65例)和机器人组(33例)。腹腔镜组患者接受传统腹腔镜骶骨阴道固定术治疗,机器人组患者接受达芬奇机器人辅助腹腔镜骶骨阴道固定术治疗。比较两组患者手术时间、术中出血量、术后留置尿管天数、腹腔引流量、肛门排气时间、术后住院天数、术中和术后并发症。比较两组患者手术前后盆腔器官脱垂量化系统(POP-Q)分度、盆底障碍影响问卷(PFIQ-7)及盆腔器官脱垂尿失禁性功能问卷(PISQ-12)评分。结果手术均顺利完成,未发生术中并发症及中转开腹。机器人组手术时间短于腹腔镜组,术中出血量少于腹腔镜组(均P<0.05)。两组术后留置尿管天数、腹腔引流量、肛门排气时间、术后住院天数比较,差异无统计学意义(均P>0.05)。机器人组短期并发症发生率、远期并发症发生率分别与腹腔镜组比较,差异无统计学意义(均P>0.05)。机器人组术后PFIQ-7评分、PISQ-12评分分别与腹腔镜组比较,差异无统计学意义(均P>0.05)。两组术后PFIQ-7评分均低于同组术前,两组术后PISQ-12评分均高于同组术前(均P<0.05)。两组术后3个月POP-Q评分比较,差异无统计学意义(均P>0.05)。术后3个月,机器人组Aa、Ba、C、pb、Ap、Bp较术前改善(均P<0.05)。机器人组术后3个月gh、Tvl分别与同组术前比较,差异无统计学意义(均P>0.05)。术后3个月,腹腔镜组Aa、Ba、C、Ap、Bp较术前改善(均P<0.05)。腹腔镜组术后3个月gh、pb、Tvl分别与同组术前比较,差异无统计学意义(均P>0.05)。结论采用达芬奇机器人系统辅助腹腔镜骶骨阴道固定术治疗POP的效果确切,有助于缩短手术时间,减少术中出血。Objective To investigate the effect of da Vinci robotic-assisted laparoscopic sacrocolpopexy in the treatment of pelvic organ prolapse(POP).Methods The clinical data of 98 patients with POP(uterine and apical prolapse) admitted to the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2018 were retrospectively analyzed. According to the treatment, the patients were divided into laparoscopic group(65 cases) and robotic group(33 cases). The patients in laparoscopic group received conventional laparoscopic sacrocolpopexy, while the patients in robotic group received da Vinci robotic-assisted laparoscopic sacrocolpopexy. The operation time, intraoperative estimated blood loss, postoperative indwelling catheter days, abdominal drainage, intestinal exhaust time, the length of postoperative hospital stay, intraoperative and postoperative complications were compared between the two groups. The scores of pelvic organ prolapse quantification(POP-Q), pelvic floor impact questionnaire-7(PFIQ-7) and pelvic organ prolapse urinary incontinence sexual questionnaire-12(PISQ-12) were compared between the two groups before and after operation.Results All the surgeries were successfully completed without complications and conversion to laparotomy. The operation time in robotic group was shorter than that in laparoscopic group, and the intraoperative estimated blood loss was less than that in laparoscopic group(both P<0.05). There were no statistical differences between the two groups in the postoperative indwelling catheter days, abdominal drainage, intestinal exhaust time and the length of postoperative hospital stay(all P>0.05). The incidences of short-term complications and long-term complications in robotic group were not statistically different from those in laparoscopic group(both P>0.05). The PFIQ-7 score and PISQ-12 score after operation in robotic group were compared with those in laparoscopic group respectively with no statistical differences(both P>0.05). The postoperative PFIQ-7 scores of the

关 键 词：盆腔器官脱垂 达芬奇机器人 腹腔镜 骶骨阴道固定术 

分 类 号：R711.23[医药卫生—妇产科学]