达芬奇机器人手术系统在男性甲状腺手术中的临床应用  

Clinical application of Da Vinci robot in male thyroid surgery

作　　者：王猛 郑鲁明 周鹏 于芳 王刚 李小磊 朱见 岳涛 王丹 李丹丹 贺青卿 Wang Meng;Zheng Luming;Zhou Peng;Yu Fang;Wang Gang;Li Xiaolei;Zhu Jian;Yue Tao;Wang Dan;Li Dandan;He Qingqing(Department of Thyroid and Breast Surgery,the 960th Hospital of PLA,Jinan 250031,China)

机构地区：[1]解放军第九六O医院甲状腺乳腺外科,济南250031

出　　处：《中华内分泌外科杂志》2021年第1期15-20,共6页Chinese Journal of Endocrine Surgery

基　　金：甲状腺肿瘤微创手术机器人关键技术与平台研发(2019YFC0119205);原济南军区总医院院长基金资助项目(2016ZD02、2018ZX01)。

摘　　要：目的探讨达芬奇机器人手术系统在男性甲状腺手术应用中的安全性及手术治疗效果。方法回顾性分析2014年2月至2020年1月解放军第九六〇医院(原济南军区总医院)甲状腺乳腺外科收治的276例男性经双侧乳腺腋窝径路(bilateral axillo-breast approach,BABA)行机器人甲状腺手术患者(机器人组)的临床资料,与同期被同一团队行开放手术的372例男性患者(开放组)的临床资料进行比较,统计所有患者的手术时间、术后引流液体量、术后住院时间、淋巴结转移(lymph node metastasis,LNM)例数(恶性)、美容效果满意度及手术并发症等。采用SPSS 20.0软件对结果进行统计学分析,计量资料比较采用t检验;计数资料比较采用χ2检验。结果所有手术均顺利完成,机器人组无中转开放手术。与开放组相比,无论病理良恶性,机器人组手术时间[良性(96.78±9.67)min,恶性(143.93±15.73)min]明显长于开放组[良性(70.40±12.49)min,恶性(112.26±15.72)min](P<0.05),但机器人组术后美容效果[良性(9.62±0.33)分,恶性(9.59±0.31)分]优于开放组[良性(5.33±0.37)分,恶性(5.87±1.65)分](P<0.05);病理恶性患者中,机器人组的平均年龄(40.89±11.45)岁低于开放组(44.84±11.88)岁(P<0.05)。两组的术后引流液体量、术后住院时间及LNM例数差异无统计学意义(P>0.05)。机器人组与开放组分别有2例和5例出现术后颈侧区淋巴结复发转移。所有患者均无永久性喉返神经损伤及永久性甲状旁腺功能减退发生。随访时间为(25.36±16.13)个月,范围为1~72个月。结论与传统开放手术相比,达芬奇机器人手术系统在男性甲状腺手术中的应用安全可行,具有更好的美容效果,为有颈部美容需求的男性甲状腺手术患者提供了新的选择。Objective To investigate the safety and surgical treatment effect of da Vinci robot in male thyroid surgery.Methods Clinical data of 276 male patients undergoing robotic thyroid surgery with bilateral axillo-breast approach(BABA)admitted to our hospital from Feb.2014 to Jan.2020 were retrospectively analyzed.They were compared with 372 male patients(open group)who had open surgery by the same team during the same time.Surgical time,the amount of fluid selitransteise after surgery,the length of hospitalization after surgery,the number of metastatic lymph node(for malignant tumor),cosmetic effect satisfaction,injury of recurrent laryngeal nerve and decrease of parathyroid function and other related surgical complications were analyzed.SPSS 20.0 software was employed to carry out statistical analysis,the measurement data were compared with ttest,and the counting data were analyzed by test.Results All operations were successfully completed and on one in the robot group was converted into open surgery.Compared with the open group,surgical time of the robot group(benign:96.78±9.67min,malignant:143.93±15.73min)was significantly longer than that of the open group(benign:70.40±12.49min,malignant:112.26±15.72min)(P<0.05),but the postoperative beauty effect of the robot group(benign:9.62±0.33 points,malignant:9.59±0.31 min)was better than that of the open group(benign:5.33±0.37 points,malignant:5.87±1.65 points)(P<0.05).In patients with pathological malignancy,the average age of the robot group(40.89±11.45 years)was lower than that of the open group(44.84±11.88 years)(P<0.05).There was no significant difference in the amount of fluid induced after surgery,the length of hospital stay after surgery or the number of cases with lymph node metastasis in the two groups(P>0.05).There were 2 cases in the robot group and 5 cases in the open surgery group had recurrent metastasis in the side of the neck after surgery.None of the patients had permanent larynx reflux nerve damage or permanent parathyroid dysfunction.The avera

关 键 词：达芬奇机器人 男性 甲状腺手术 BABA径路 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]