机器人手术在Ⅰ期卵巢交界性上皮性肿瘤的应用研究  

Research on the Application of Robotic Surgery in StageⅠBorderline Epithelial Ovarian Tumors

作　　者：郎婷玉 纪妹[1] 何南南[1] 赵曌[1] 荆兆鹏 曾佳 张婷[1] LANG Tingyu;JI Mei;HE Nannan(Department of Gynecology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学第一附属医院妇科,河南郑州450000

出　　处：《实用妇产科杂志》2021年第10期777-782,共6页Journal of Practical Obstetrics and Gynecology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20190122)。

摘　　要：目的:探讨机器人手术(RALS)在国际妇产科联盟(FIGO)分期Ⅰ期卵巢交界性上皮性肿瘤(BOT)中的应用价值。方法:收集郑州大学第一附属医院在2014年9月至2019年9月收治的286例FIGOⅠ期BOT患者的临床资料。按不同的手术方式分为3组:开腹手术(LAP)组、腹腔镜手术(TLS)组和RALS组。对各组的围手术期及预后相关指标进行回顾性分析。结果:LAP组术中出血量和术后肛门排气时间(保留生育手术121.88±52.21 ml、根治手术149.17±38.95 ml;2.57±0.59天)多于TLS组(41.48±34.41 ml、60.00±23.58 ml;2.34±0.60天)和RALS组(28.89±27.55 ml、40.00±8.94 ml;2.31±0.52天),差异有统计学意义(P<0.05),而微创两组相比差异无统计学意义(P>0.05)。3组(LAP、TLS、RALS)手术时间(保留生育手术148.25±57.65分钟、115.27±26.93分钟、196.17±25.35分钟;根治手术175.67±59.59分钟、144.90±31.36分钟、233.67±39.91分钟)、术后住院时间(10.83±4.96天、6.32±2.07天、5.21±1.62天)、并发症发生率(43.33%、26.63%、9.52%),两两相比差异有统计学意义(P<0.05),3组预后指标(术后半年月经恢复情况、3年复发率、妊娠情况)相比差异无统计学意义(P>0.05),随访期间生存率100%。结论:RALS用于BOT FIGOⅠ期患者是安全的,对患者的创伤小于行LAP和TLS的患者,但费用和手术时间处于劣势,术后恢复情况和近期复发情况无明显差异。因此手术方案的选择应结合手术医师技术、患者病情及经济状况综合衡量。Objective:To explore the application value of robot assisted laparoscopic surgery(RALS)in FIGO stageⅠborderline ovarian tumors(BOT).Methods:The clinical data of 286 patients of FIGO stageⅠBOT admitted to The First Affiliated Hospital of Zhengzhou University from September 2014 to September 2019 were collected.According to different surgical methods,they were divided into 3 groups,open laparotomy(LAP)group,traditional laparoscopic surgery(TLS)group and RALS group.Perioperative and prognostic indicators of each group were retrospectively analysed.Results:Intraoperative blood loss and postoperative anal exhaust time in the LAP group(fertility preservation 121.88±52.21 ml,radical cure 149.17±38.95 ml;2.57±0.59 d)were more than those in the TLS group(41.48±34.41 ml,60.00±23.58 ml;2.34±0.60 d)and RALS group(28.89±27.55 ml,40.00±8.94 ml;2.31±0.52 d).The differences were statistically significant(P<0.05).There was no statistically significant difference between the two groups of minimally invasive surgery(P>0.05)when comparing those indicators.The operation time of the three groups(preserved fertility 148.25±57.65 min,115.27±26.93 min,196.17±25.35 min;radical cure 175.67±59.59 min,144.90±31.36 min,233.67±39.91 min),postoperative hospital stay(10.83±4.96 d,6.32±2.07 d,5.21±1.62 d),and the incidence of complications(43.33%,26.63%,9.52%)were significantly different between each two groups(P<0.05).There was no significant difference in prognostic indexes(menstrual recovery in half a year after operation,3-year recurrence rate and pregnancy)among the three groups(P>0.05).The survival rate during follow-up was 100%.Conclusions:RALS is safe for BOT FIGO stageⅠpatients,with less trauma than LAP and TLS patients,but the cost and operation time are at a disadvantage,and there is no significant difference between postoperative recovery and recent recurrence.Therefore,the choice of surgical plan should be comprehensively evaluated in combination with the skills of the surgeon,the patient′s condition and eco

关 键 词：卵巢交界性上皮性肿瘤 机器人手术系统 腹腔镜手术 开腹手术 

分 类 号：R737.31[医药卫生—肿瘤]