机器人辅助腹腔镜与传统腹腔镜宫颈癌手术的临床对比研究  

Clinical comparison between traditional and robotassisted laparoscopic radical hysterectomy in treatment of cervical cancer

作　　者：李津津 欧阳熙坪 龚雪[1] 黎埔君 肖琳[1] 胡琢瑛[1] 邓幼林[1] 罗祎[1] 唐均英[1] LI Jinjin;OUYANG Xiping;GONG Xue;LI Pujun;XIAO Lin;HU Zhuoying;DENG Youlin;LUO Yi;TANG Junying(Department of Gynecology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院妇科,重庆400016

出　　处：《机器人外科学杂志（中英文）》2020年第3期166-173,共8页Chinese Journal of Robotic Surgery

基　　金：重庆市科委项目(cstc2015shmszx120085)。

摘　　要：目的:比较机器人辅助腹腔镜与传统腹腔镜宫颈癌手术患者的临床资料,探讨机器人辅助腹腔镜手术的安全性、可行性以及优势。方法:回顾性分析2016年2月~2019年11月重庆医科大学附属第一医院妇科同期行机器人辅助腹腔镜宫颈癌手术400例患者(R组)和传统腹腔镜宫颈癌手术376例患者(L组)的临床资料,比较研究两组患者的基线特征、手术时间、术中出血量、术后首次排气时间、术后住院日、淋巴结切除数目、术中及术后并发症等。结果:R组的术中失血量少于L组[(87.02±71.88)ml Vs(123.28±93.87)ml]、术后首次肛门排气时间短于L组[(1.90±0.64)d Vs(2.05±0.69)d]、术后住院时间短于L组[(6.57±1.20)d Vs(8.51±2.55)d],淋巴结清扫数目多于L组[(35.84±15.16)枚Vs(27.33±10.63)枚],差异均有统计学意义(P<0.05)。两组手术时间、术中及术后并发症比较,差异均无统计学意义(P>0.05)。结论:机器人辅助腹腔镜宫颈癌手术具有淋巴结切除数目多、术中出血少、肛门排气时间早、术后住院时间短等优势,可见机器人手术在宫颈癌的治疗中是安全可行的。同时达芬奇机器人系统在放化疗未控、晚期局部复发转移、早期保留生育功能、局部晚期等高难度的宫颈癌手术方面具有优势。Objective:To explore the safety,feasibility and other advantages of robot-assisted laparoscopic radical hysterectomy over traditional laparoscopic radical hysterectomy in treatment of cervical cancer.Methods:The clinical data of 400 patients who underwent robot-assisted laparoscopic radical hysterectomy(R group)and 376 patients who underwent traditional laparoscopic radical hysterectomy(L group)from February 2016 to November 2019 in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.The baseline characteristics,operation time,intraoperative blood loss,postoperative anal exhaust time,postoperative hospital stay,the number of dissected lymph nodes,intraoperative and postoperative complications,etc.were compared and analyzed between two groups.Results:The intraoperative blood loss of R group is significantly less than L group[(87.02±71.88)ml Vs(123.28±93.87)ml](P<0.05).Comparing with L group,postoperative anal exhaust time[(1.90±0.64)d Vs(2.05±0.69)d]and postoperative hospital stay[(6.57±1.20)d Vs(8.51±2.55)d]were significantly shorter in R group(P<0.05),number of dissected lymph nodes[(35.84±15.16)Vs(27.33±10.63)]were significantly more in R group(P<0.05).There were no significant differences in the operative time,intraoperative and postoperative complications between two groups(P>0.05).Conclusion:With more number of dissected lymph nodes,less intraoperative blood loss,shorter anal exhaust time and postoperative hospital stay,robot-assisted laparoscopic radical hysterectomy is safe and feasible.Meanwhile,robotic surgery is also superior to traditional laparoscopy in complicated cervical cancer surgeries,such as failing to control after radiotherapy and chemotherapy,local recurrence and metastasis in advanced stage,preserve the fertility in early stage,as well as locally advanced cervical cancer.

关 键 词：宫颈癌 机器人辅助腹腔镜 腹腔镜 

分 类 号：R713[医药卫生—妇产科学]