“腹直肌外直线法”操作通道布局在机器人辅助腹腔镜上尿路尿路上皮癌根治术中的应用  

Application of the Operation Channel Layout of the“External Straight Line Method of the Musculus Rectus Abdominis”in the Robot-assisted Laparoscopic Nephroureterectomy for Upper Tract Urothelial Carcinoma

作　　者：毛祖杰[1] 喻晓芬[2] 沃奇军[1] Mao Zujie;Yu Xiaofen;Wo Qijun(Department of Urology,Zhejiang Provincial People’s Hospital,People’s Hospital of Hangzhou Medical College,Hangzhou 310014,China;不详)

机构地区：[1]浙江省人民医院,杭州医学院附属人民医院泌尿外科,杭州310014 [2]浙江省人民医院,杭州医学院附属人民医院手术室,杭州310014

出　　处：《中国微创外科杂志》2022年第2期108-113,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：浙江省医药卫生科技计划项目(2018KY212)。

摘　　要：目的探讨单机位机器人辅助腹腔镜上尿路尿路上皮癌(upper tract urothelial carcinoma,UTUC)根治术“腹直肌外直线法”操作通道布局的合理性。方法2014年9月~2017年5月,我们对31例UTUC术中通过头、足侧2次床旁机械臂系统定泊完成手术操作(对照组),2017年6月~2020年1月对35例UTUC采用“腹直肌外直线法”操作通道布局单机位完成手术操作(观察组),比较2组手术方式改变、手术时间、术中出血量、术中淋巴结清扫数目和医护满意度。结果观察组手术时间(147.3±28.3)min,显著短于对照组(162.1±16.4)min(t=2.540,P=0.014);在操作便利、减少器械护士工作量、减少巡回护士工作量、总体评价4个维度,观察组得分明显高于对照组(均P=0.000)。2组手术方式未改变,术中出血量、淋巴结清扫数目差异无统计学意义(均P>0.05)。结论“腹直肌外直线法”操作通道布局能使单机位机器人辅助腹腔镜UTUC根治术顺利完成,缩短手术时间,充分发挥机器人手术优势,提高医护工作人员的满意度。Objective To investigate the rationality of operation channel layout of the“external straight line method of the musculus rectus abdominis”in single-docking robot-assisted laparoscopic nephroureterectomy for upper tract urothelial carcinoma(UTUC).Methods From September 2014 to May 2017,we completed operations of 31 cases of UTUC through twice docking of the bedside mechanical arm system on the head and feet(control group).From June 2017 to January 2020,we completed operations of 35 cases of UTUC with the operation channel layout of“external straight line method of the musculus rectus abdominis”in single-docking operations(observation group).We compared the changes of operation mode,operation time,intraoperative bleeding,intraoperative lymph node dissection number and medical staff satisfaction between the two groups.Results The operation time was(147.3±28.3)min in the observation group and(162.1±16.4)min in the control group,which showed a significant difference(t=2.540,P=0.014).The scores of the observation group were higher than those of the control group in four dimensions:performance convenience,reduced workload of equipment nurses,reduced workload of itinerant nurses,and overall evaluation(all P=0.000).The operative modes of the two groups remained unchanged.There was no significant difference in the amount of bleeding and the number of lymph node dissections between the two groups(all P>0.05).Conclusions The single-docking robot-assisted laparoscopic nephroureterectomy can be successfully implemented with operation channel layout of the“the external straight line method of the musculus rectus abdominis”for UTUC.It significantly shortens the operation time,makes full use of robot advantages,and improves medical staff satisfaction.

关 键 词：机器人辅助腹腔镜手术 上尿路尿路上皮癌 腹直肌外直线法 

分 类 号：R47[医药卫生—护理学]