三维影像重建技术辅助机器人手术系统在宫颈癌根治术中的应用  

Application of 3D image reconstruction technology in robot-assisted radical hysterectomy

作　　者：张琦玲 杨蕾[1] 张智[1] 付振华 蔡丽萍[1] ZHANG Qiling;YANG Lei;ZHANG Zhi;FU Zhenhua;CAI Liping(Department of Gynecologic Oncology,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院妇产科,江西南昌330000

出　　处：《机器人外科学杂志（中英文）》2020年第2期117-123,共7页Chinese Journal of Robotic Surgery

摘　　要：目的:探讨三维重建技术在机器人宫颈癌手术中的应用价值。方法:回顾性分析2019年1月~2019年9月南昌大学第一附属医院妇产科收治的23例行宫颈癌(IB1~IIA2)根治术患者的临床资料,其中三维影像重建技术辅助机器人手术系统行宫颈癌根治术10例(干预组),单纯机器人腹腔镜宫颈癌根治术13例(对照组)。对比两组手术时间、术中出血量、淋巴结切除数目、胃肠道功能恢复时间,术后拔除尿管时间、手术并发症发生率等。结果:23例患者均顺利完成手术,无中转开腹及输血。干预组和对照组手术时间分别为(155.30±12.22)min和(182.77±6.83)min,术中出血量分别为(67.80±9.39)ml和(76.92±6.18)ml。术中无膀胱、输尿管及肠管损伤。术后胃肠道功能恢复时间分别为(29.50±5.56)h和(42.31±4.70)h,术后拔除尿管时间分别为(15.60±2.12)d和(22.38±3.86)d,两组手术并发症发生率分别为10.00%和30.77%。以上指标比较,差异均有统计学意义(P<0.05)。但两组的淋巴结切除数目分别为(24.60±2.50)枚和(22.62±2.26)枚,差异无统计学意义(P>0.05)。术后病理诊断均与术前相符,阴道和宫旁切缘均为阴性,均未进行放化疗,且随访研究发现恢复良好。结论:在宫颈癌根治术中,三维影像重建技术辅助机器人手术系统优势较为明显,相关并发症发生率低,且术中组织和器官损伤减轻。Objective:To explore the application value of 3D reconstruction technology in robot-assisted radical hysterectomy.Methods:The clinical data of 23 patients underwent radical hysterectomy(IB1-IIA2)in Obstetrics and Gynecology Department of the First Affiliated Hospital of Nanchang University from January 2019 to September 2019,among which 10 cases underwent robot-assisted radical hysterectomy supported by 3D image reconstruction technology(intervention group)and 13 cases underwent robot-assisted laparoscopic radical hysterectomy(control group).The operation time,intraoperative blood loss,number of dissected lymph nodes,gastrointestinal function recovery time,catheter removing time,incidence of operative complications of the two groups were compared.Results:23 patients were all successfully completed the operation without conversion to laparotomy or blood transfusion.The operative time of intervention group and control group were(155.30±12.22)min and(182.77±6.83)min respectively with an intraoperative bleeding volume of(67.80±9.39)ml and(76.92±6.18)ml.No injury of bladder,ureter and intestine were found.The gastrointestinal function recovery time of intervention group and control group were(29.50±5.56)h and(42.31±4.70)h respectively,and the catheter removing time were(15.60±2.12)d and(22.38±3.86)d.The incidence of operative complications in intervention group and control group were 10.00%and 30.77%respectively.All the above indexes were statistically significant(P<0.05).However,the number of dissected lymph nodes in intervention group and control group were(24.60±2.50)and(22.62±2.26)respectively,which has no significant difference(P>0.05).The postoperative pathological diagnosis was consistent with preoperative diagnosis.The vaginal and parametrial margins were all negative and no radiotherapy or chemotherapy was performed.The patients were well recovered in followup study.Conclusion:Robotic surgery system assisted by 3D image reconstruction technology brings advantages in radical hysterectomy,such as less

关 键 词：三维影像重建技术 机器人手术 宫颈癌根治术 

分 类 号：R713.4[医药卫生—妇产科学]