机器人外科手术系统在甲状腺癌再次手术中的临床应用  

Clinical application of robotic surgical system in re-operation of thyroid cancer

作　　者：王丹 朱见 王军 刘长瑞 翟东亮 明珊珊 贺青卿 Wang Dan;Zhu Jian;Wang Jun;Liu Changrui;Zhai Dongliang;Ming Shanshan;He Qingqing(Department of Thyroid and Breast Surgery,the 960th Hospital of the People′s Liberation Army of China,Ji′nan 250031,China)

机构地区：[1]解放军联勤保障部队第九六〇医院甲状腺乳腺外科,济南250031

出　　处：《国际外科学杂志》2023年第5期344-348,F0004,共6页International Journal of Surgery

基　　金：国家科技部重点研发计划专项课题子课题(2019YFC0119205)。

摘　　要：目的探讨达芬奇机器人外科手术系统在甲状腺癌复发或残留再次手术中应用的可行性、安全性和有效性。方法回顾性描述分析2018年9月—2022年1月解放军联勤保障部队第九六〇医院收治的9例达芬奇机器人辅助下甲状腺癌再次手术患者的临床资料,统计手术时间、清扫淋巴结数目、术中出血量、住院时间、术后总引流量、并发症发生情况、术后美容效果满意度、术后24 h疼痛视觉模拟评分(VAS)及随访期间复发人数。结果9例患者手术时间(186.67±44.44)min、清扫淋巴结数目(15.77±13.59)枚、术中出血量(21.11±16.91)mL、住院时间(10.67±3.32)d、术后总引流量(286.94±90.85)mL,无并发症发生,所有患者术后美容效果满意,VAS为(8.22±1.09)分,术后24 h疼痛VAS评分0~3分,平均(2.44±0.73)分,随访6~46个月期间均无再次复发。结论充分术前评估和术者团队经验丰富的情况下,机器人在甲状腺癌复发或残留再次手术中的应用是可行、安全和有效的。Objective To investigate the feasibility,safety and effectiveness of Da Vinci robotic surgical system in the reoperation of recurrent or residual thyroid cancer.Methods Retrospective analysis was performed on the clinical data of 9 patients with Da Vinci robot-assisted reoperation for thyroid cancer in the 960th Hospital of the People′s Liberation Army of China from September 2018 to January 2022,the operation time,number of lymph nodes dissected,intraoperative blood loss,length of hospital stay,total postoperative drainage volume,incidence of complications,satisfaction with postoperative aesthetic effect,visual analyogue scale(VAS)score at the 24 h after surgery and number of recurrence during follow-up were counted.Results The surgery time of 9 cases was(186.67±44.44)min,the number of lymph nodes cleared were(15.77±13.59),intraoperative blood loss was(21.11±16.91)mL,hospital stay were(10.67±3.32)days,total postoperative drainage was(286.94±90.85)mL.There was no complications,and all patients were satisfied with the postoperative cosmetic effect whose VAS score was(8.22±1.09),and VAS score was 0 to 3(2.44±0.73)points,no recurrence during the follow-up period from 6 to 46 months.Conclusion With adequate preoperative evaluation and an experienced surgeon team,the use of robots in recurrent or residual thyroid cancer resurgery is feasible,safe and effective.

关 键 词：甲状腺肿瘤 复发 淋巴结 达芬奇机器人 再次手术 

分 类 号：R736.1[医药卫生—肿瘤]