达芬奇机器人系统治疗子宫内膜癌415例分析  

Analysis of 415 cases of endometrial cancer treated with Da Vinci robotic system

作　　者：翟梁好 董健 荆茹 周福兴 魏莉 陈必良 ZHAI Lianghao;DONG Jian;JING Ru;ZHOU Fuxing;WEI Li;CHEN Biliang(Department of Obstetrics and Gynecology,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院妇产科,陕西西安710032

出　　处：《空军军医大学学报》2023年第9期857-861,共5页Journal of Air Force Medical University

基　　金：国家自然科学基金(82002735,81972440)。

摘　　要：目的分析达芬奇机器人手术系统治疗子宫内膜癌患者的围术期结果,临床病理特征,预后及其在子宫内膜癌手术中的安全性、可行性和应用优势,为临床应用提供参考。方法回顾性分析空军军医大学西京医院妇产科2014年5月至2020年12月收治的415例采用机器人手术初治的子宫内膜癌患者临床资料,分析手术时间、术中出血量、肿瘤病理特征、淋巴结切除数目、术后肛门排气时间、住院时间、术后并发症情况及生存预后。结果子宫内膜癌患者平均发病年龄(53.35±9.35)岁;平均体质量指数(BMI)为(25.14±3.88)kg/m^(2),肥胖患者(BMI>28 kg/m^(2))占19.28%;合并代谢综合征患者占32.05%;未生育患者占5.54%。机器人手术平均手术时间(178.44±54.07)min,平均术中出血量(57.90±43.63)mL,平均淋巴结切除数量(22.32±8.25)枚。平均术后排气时间(1.01±0.34)d,平均术后住院时间(5.79±1.57)d。Ⅰ型子宫内膜癌患者占92.77%,Ⅱ型子宫内膜癌占7.23%;Ⅰ型子宫内膜癌Ⅰ期患者占77.59%,Ⅱ期占9.64%,Ⅲ期占11.81%,Ⅳ期占0.96%。415例达芬奇机器人手术治疗子宫内膜癌患者的3年累积生存率94.2%,5年累积生存率93.4%;3年无病生存率为93.4%,5年无病生存率为90.4%。结论达芬奇机器人手术系统治疗子宫内膜癌稳定性强、精确度高,手术效果不受患者年龄、肥胖、复杂合并症等多元化临床特征影响。Objective To analyze the perioperative outcomes,clinicopathological characteristics and prognosis of the patients with endometrial cancer treated with Da Vinci robotic surgery system,and to investigate the safety,feasibility and application advantages of this system in endometrial cancer treatment,providing reference for clinical application.Methods The clinical data of 415 patients with endometrial cancer treated by robotic surgery in the Department of Obstetrics and Gynecology,Xijing Hospital,Air Force Medical University from May 2014 to December 2020 were retrospectively analyzed for operative time,intraoperative blood loss,pathological features of tumor,number of excised lymph nodes,postoperative anal exhaust time,hospital stay,postoperative complications and survival prognosis.Results The average age of onset of patients with endometrial cancer was(53.35±9.35)years.The average body mass index(BMI)was(25.14±3.88)kg/m^(2),and the obese patients(BMI>28 kg/m^(2))accounted for 19.28%.Patients with metabolic syndrome accounted for 32.05%and nulliparous patients accounted for 5.54%.The average operative time of robotic surgery was(178.44±54.07)min,the average intraoperative blood loss was(57.90±43.63)mL,and the average number of excised lymph nodes was 22.32±8.25.The average postoperative exhaust time was(1.01±0.34)d,and the average postoperative hospital stay was(5.79±1.57)d.Patients with typeⅠendometrial cancer accounted for 92.77%,and patients with typeⅡendometrial cancer accounted for 7.23%.The proportion of patients with typeⅠendometrial cancer was 77.59%in stageⅠ,9.64%in stageⅡ,11.81%in stageⅢand 0.96%in stageⅣ.The 3-and 5-year cumulative survival rates of 415 patients with endometrial cancer treated by Da Vinci robotic surgery were 94.2%and 93.4%,respectively.The 3-and 5-year disease-free survival rates were 93.4%and 90.4%,respectively.Conclusion Da Vinci robotic surgery system has high stability and accuracy in the treatment of endometrial cancer.The surgical effect is not affected by d

关 键 词：子宫内膜癌 达芬奇机器人 累积生存率 

分 类 号：R737.33[医药卫生—肿瘤]