达芬奇机器人手术操作系统辅助子宫内膜癌全面分期手术在高龄患者中的应用  

Application of Da Vinci surgical system-assisted comprehensive staging surgery for elderly patients with endometrial carcinoma

作　　者：常淑珍 张威[1] 彭鳞钰 周海燕 刘丽雅[1] 韩丽萍[1] CHANG Shuzhen;ZHANG Wei;PENG Linyu;ZHOU Haiyan;LIU Liya;HAN Liping(Department of Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院妇科,河南郑州450052

出　　处：《肿瘤基础与临床》2022年第2期127-131,共5页journal of basic and clinical oncology

基　　金：国家自然科学基金面上项目(U1604172);河南省自然科学基金面上项目(212300410394);河南省省部共建项目(LHGJ20200346)。

摘　　要：目的探讨达芬奇机器人手术操作系统(DVSS)辅助子宫内膜癌全面分期手术治疗高龄(≥70岁)子宫内膜癌患者的安全性和有效性。方法选取2015年1月至2020年9月间在郑州大学第一附属医院接受子宫内膜癌全面分期手术的年龄≥70岁的患者44例,根据其手术方式的不同分为机器人组(23例)和腹腔镜组(21例),对2组患者的手术时间、术中出血量、淋巴结清扫数目、术后肛门排气时间、术后尿管拔除时间、住院时间、住院费用、术中并发症、术后并发症、术后复发率等指标进行对比分析。结果与腹腔镜组相比,机器人组术中出血少、淋巴结清扫数目多同时术后住院时间短(Z=2.511,P=0.012;t=2.876,P=0.012;Z=2.048,P=0.041);机器人组手术时间长,住院费用高(t=2.099,P=0.042;t=10.432,P=0.028)。2组患者术后肛门排气时间、术后尿管拔除时间、术中并发症发生率、术后并发症发生率、复发率比较差异均无统计学意义(Z=0.311,P=0.756;Z=1.005,P=0.315;P>0.999;P=0.693;P>0.999)。结论与DVSS辅助子宫内膜癌全面分期手术相较于传统腹腔镜手术,在高龄患者中应用具有一定的优势,是安全可行的。Objective To investigate the safety and efficacy of Da Vinci surgical system(DVSS)-assisted comprehensive staging surgery for patients with endometrial cancer(≥70 years old).Methods A total of 44 elderly patients with endometrial cancer(≥70 years old)who received comprehensive staging surgery for endometrial cancer in the First Affiliated Hospital of Zhengzhou University from January 2015 to September 2020 were selected and divided into the robot group(n=23)and the laparoscope group(n=21)according to different surgical methods.The operation time,intraoperative blood loss,number of lymph node dissection,postoperative anus recovery time,postoperative catheter removal time,hospitalization time,hospitalization cost,intraoperative complications,postoperative complications,postoperative recurrence rate were compared between the two groups.Results Compared to laparoscopic group,robotic group had less intraoperative bleeding,more lymph node dissection and shorter postoperative hospital stay(Z=2.511,P=0.012;t=2.876,P=0.012;Z=2.048,P=0.041);therobotic group had longer operation time and higher hospitalization costs(t=2.099,P=0.042;t=10.432,P=0.028).There was no significant difference in postoperative anal exhaust time,postoperative catheter extraction time,intraoperative complication rate,postoperative complication rate and recurrence rate between the two groups(Z=0.311,P=0.756;Z=1.005,P=0.315;P>0.999;P=0.693;P>0.999).Conclusion DVSS-assisted comprehensive staging surgery for endometrial carcinoma is safe and feasible in the elderly patients.

关 键 词：子宫内膜癌 子宫内膜癌全面分期手术 达芬奇手术操作系统 腹腔镜手术 

分 类 号：R737.33[医药卫生—肿瘤]