机器人与腹腔镜左半结肠癌根治性切除术近期疗效对照研究  

Contrast study of short-term effect between the robot and laparoscopic technology in left hemicolectomy for colon carcinoma

作　　者：孙焕奎 李太原[1] 温祥琼 郑林林 胡家平[1] SUN Huankui;LI Taiyuan;WEN Xiangqiong;ZHENG Linlin;HU Jiaping(The First Affil-iated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院普外科,南昌330000

出　　处：《实用医学杂志》2020年第18期2551-2554,2558,共5页The Journal of Practical Medicine

摘　　要：目的通过对比机器人与腹腔镜手术治疗左半结肠癌的近期疗效,评估机器人辅助左半结肠癌根治术的可行性和安全性。方法回顾性收集2017年1月至2019年6月南昌大学第一附属医院收治的195例行左半结肠癌根治术的患者临床资料,其中105例行机器人辅助左半结肠癌根治性切除术(机器人组),90例行腹腔镜辅助左半结肠癌根治性切除术(腹腔镜组)。统计手术时间、术中出血量、切除淋巴结总数、转移淋巴结总数、术后住院时间、术后首次排气时间、首次下床活动时间、流质饮食时间、术后并发症、切口总长度、术后第1天疼痛评分、住院费用等临床数据。结果两组均无围手术期死亡病例。机器人组与腹腔镜组中转开腹率、淋巴结清扫数目、术后住院时间、流质饮食时间、术后第1天疼痛评分、术后并发症比较差异无统计学意义(P>0.05)。机器人组较腹腔镜组术中出血量更少[(133±92)mL vs.(147±75)mL,t=7.217,P<0.05],首次排气时间更早[(47.4±16.2)h vs.(52.7±11.3)h,t=-2.425,P<0.05],首次下床活动时间更快[(25.9±1.1)h vs.(28.2±2.1)h,t=-9.431,P<0.05],切口总长度更短[(5±1)cm vs.(7±3)cm,t=-4.735,P<0.05]。结论左半结肠癌患者行机器人辅助左半结肠癌根治性切除术安全可行;与腹腔镜手术相比,其术中出血少,且术后恢复较腹腔镜更快。Objective To evaluate the feasibility and safety of robot assisted left hemicolon cancer radical surgery by comparing the short-term efficacy of robot and laparoscopic surgery.Methods The clinical data of 195 patients with left hemicolectomy admitted to the First Affiliated Hospital of Nanchang University from January 2017 to June 2019 were retrospectively collected,including 105 patients with robot assisted left hemicolectomy(robot group)and 90 patients with laparoscopic assisted left hemicolectomy(laparoscopic group).The clinical data of operation time,intraoperative hemorrhage,total number of lymph nodes removed,total number of lymph nodes metastasized,postoperative hospitalization time,first postoperative exhaust time,first time out of bed activity time,fluid diet time,postoperative complications,total length of incision,pain score on the first day after operation,cost of living in hospital,etc.were analyzed.Results There were no perioperative deaths in both groups.There was no significant difference between the robot group and the laparoscopic group in the conversion rate,the number of lymph node dissection,postoperative hospital stay,fluid diet time,first day postoperative pain score and postop-erative complications(P>0.05).In the robot group,the bleeding volume was less than that in the laparoscopy group[(133±92)mL vs.(147±75)mL,t=7.217,P<0.05],the first time to exhaust was earlier[(47.4±16.2)h vs.(52.7±11.3)h,t=-2.425,P<0.05],the first time to get out of bed was faster[(25.9±1.1)h vs.(28.2±2.1)h,t=-9.431,P<0.05],the total length of incision was shorter[(5±1)cm vs.(7±3)cm,t=-4.735,P<0.05].Conclusion Compared with laparoscopic surgery,robot assisted radical resection of left hemicolon for patients with left hemicolon cancer has less bleeding and faster postoperative recovery,indicating that this surgical approach is safe and feasible.

关 键 词：结肠癌 左半结肠切除术 达芬奇机器人手术系统 腹腔镜 

分 类 号：R735.3[医药卫生—肿瘤]