达芬奇机器人辅助腹腔镜与传统腹腔镜在超重及肥胖的高龄子宫内膜癌患者中的疗效对比分析  

Comparative Analysis of the Efficacy of Da Vinci Robot-Assisted Laparoscopy and Traditional Laparoscopy in Elderly Overweight and Obese Patients with Endometrial Cancer

作　　者：赵施旖 纪妹[1] 赵曌[1] 何南南[1] 李悦[1] 张婷[1] ZHAO Shiyi;JI Mei;ZHAO Zhao(Department of Gyn ecology,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》2023年第3期200-204,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:通过比较达芬奇机器人辅助腹腔镜与传统腹腔镜应用于超重及肥胖的高龄子宫内膜癌患者的疗效,探讨达芬奇机器人手术的优势。方法:采用回顾性队列研究,收集2014年1月至2021年12月在郑州大学第一附属医院妇科初治并通过达芬奇机器人辅助腹腔镜或传统腹腔镜行子宫内膜癌全面分期手术的60岁以上超重和肥胖(体质量指数≥24 kg/m^(2))患者244例,根据手术入路将其分为机器人组(66例)和腹腔镜组(178例),比较两组的术中、术后及随访情况。结果:与腹腔镜组相比,机器人组术中出血量少(50ml vs.60ml),术后住院时间短(7.0±3.0天vs.8.3±3.0天),而总淋巴结切除数多(23.0±7.3枚vs.20.0±8.7枚),腹主动脉旁淋巴结切除数较多(6.5枚vs.3.0枚),差异均有统计学意义(P<0.05)。两组手术时间、总住院时间、盆腔淋巴结切除数、淋巴结转移情况、术后肛门排气时间、术后并发症发生率差异均无统计学意义(P>0.05)。共233例患者获得术后随访资料,中位随访时间为43月,两组的3年无复发生存率和3年总体生存率差异均无统计学意义(P>0.05)。结论:达芬奇机器人辅助腹腔镜手术治疗超重及肥胖的高龄子宫内膜癌患者安全可行,与传统腹腔镜手术相比,术中出血量更少,术后住院时间更短,术野暴露更清晰使得淋巴结切除数更多,在手术过程中具有优势,且远期疗效无明显差异,是超重和肥胖的高龄子宫内膜癌患者全面分期手术更好的选择。Objective:To compare the efficacy of Da Vinci robot-assisted laparoscopy with traditional laparoscopy in elderly overweight and obese patie nts with en dometrial cancer,a nd to evaluate the advan tages of Da Vinci robotic surgery.Methods:A retrospective cohort study was con ducted to collect 244 overweight and obese(body mass index≥24 kg/m^(2))patie nts over 60 years old who were initially treated in the Department of Gyn ecology of the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2021 and underwent comprehensive staging surgery for endometrial cancer assisted by Da Vinci robot or traditional laparoscope.They were divided into robotic group(66 cases)a nd traditional laparoscopic group(178 cases),and the intraoperative,postoperative and follow-up outcomes of the two groups were compared.Results:Compared with the traditional laparoscopic group,the robotic group had less intraoperative blood loss(50 ml vs.60 ml),shorter postoperative hospital stay(7.0±3.0 days vs.8.3±3.0 days),more total lymph node resections(23.0±7.3 vs.20.0±8.7)and more para aortic lymph node resections(6.5 vs.3.0).The difference was statistically significant(P<0.05).There was no significant difference between the two groups in operation time,length of hospital stay,number of pelvic lymph node resections,lymph node metastasis,postoperative anal exhaust time,and total postoperative complications(P>0.05).A total of 233 patients were followed up after surgery,with total median follow-up time of 43 months.There was no significant differenee in the 3-year relapse-freesurvival rate and 3-year overall survival rate between the two groups(P>0.05).Conclusions:Da Vinci robot-assisted laparoscopic surgery is safe and feasible for the treatment of overweight and obese elderly patients with endometrial cancer.Compared with traditional laparoscopic surgery,it has lessintraoperative bleeding,shorter postoperative hospital stay,clearer surgical field,and therefore more lymph nodes removed.It has advantages in the operation

关 键 词：子宫内膜癌 达芬奇机器人 高龄 超重 肥胖 

分 类 号：R737.33[医药卫生—肿瘤]