耻骨上入路机器人辅助结肠次全切除术效果评价  

Evaluation of the application of the suprapubic approach in da Vinci robot-assisted subtotal colectomy

作　　者：刘芮宏 官文龙[1] LIU Rui-hong;GUAN Wen-long(Department of Colorectal Surgery,First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院结直肠外科,黑龙江哈尔滨150001

出　　处：《中国实用外科杂志》2023年第10期1162-1165,共4页Chinese Journal of Practical Surgery

基　　金：黑龙江省普通本科高等学校青年创新人才培养计划项目(No.31011180065)。

摘　　要：目的评价耻骨上入路方式在达芬奇机器人辅助结肠次全切除术中的应用效果。方法回顾性分析2019年10月至2023年3月哈尔滨医科大学附属第一医院结直肠外科收治的使用机器人Xi系统行结肠次全切除术的17例慢传输型便秘病人的临床资料,其中采用脐周入路7例(脐周入路组),采用耻骨上入路10例(耻骨上入路组)。比较两组病人术中、术后恢复情况及门诊随访情况,并采用视觉模拟评分法(VAS)和切口美观满意度量表对病人进行术后自我评价调查。结果脐周入路组和耻骨上入路组手术时间[(250.7±59.7)min vs.(197.3±36.7)min]、术中出血量[(77.1±18.0)mL vs.(55.0±16.5)mL]、切口满意度评分[(15.7±0.8)分vs.(17.1±1.0)分]比较差异均有统计学意义(t=2.295、2.626、3.102,P均<0.05),术后首次排便时间、离床活动时间、住院时间、VAS评分比较差异均无统计学意义(P均>0.05)。门诊随访结果显示,两组病人术后3个月排便频次、排便形状比例比较差异均无统计学意义(P均>0.05)。结论在机器人辅助结肠次全切除术,耻骨上入路较脐周入路能够缩短手术时间、减少术中出血量,并提高病人对切口的满意度,且两种入路方式病人术后预后相近。Objective To evaluate the application of the suprapubic approach in da Vinci robot-assisted subtotal colectomy.Methods A retrospective analysis of the clinical data of 17 patients with slow transit constipation who underwent subtotal colectomy via linear approach(linear approach group,n=7)and subtotal colectomy via suprapubic approach(suprapubic approach group,n=10)using the da Vinci robot Xi system in the Department of Colorectal Surgery,First Affiliated Hospital of Harbin Medical University,from October 2019 to March 2023 was conducted.The two groups'intraoperative,postoperative recovery,and outpatient follow-up were compared,and the patients were evaluated using a visual analog scale(VAS)and incision aesthetic satisfaction scale.Results The operative time[(250.7±59.7)min vs.(197.3±36.7)min],intraoperative bleeding volume[(77.1±18.0)mL vs.(55.0±16.5)mL],score of incision satisfaction[(15.7±0.8)points vs.(17.1±1.0)points]of the linear approach group and the suprapubic approach group were showed statistically significant differences(t=2.295,2.626,3.102,P<0.05).There were no statistically significant differences in the time of first defecation,ambulation time,hospital stay,and VAS scores after surgery(P>0.05).Outpatient follow-up results showed no statistically significant difference between the two groups in defecation frequency and proportion of defecation shape three months after surgery(P>0.05).Conclusion Subtotal colectomy via the suprapubic approach can shorten the operation time,reduce intraoperative bleeding,and improve patient satisfaction with the incision compared to the linear approach.The prognosis of patients through the two methods is similar.

关 键 词：结肠次全切除术 机器人手术 耻骨上入路 

分 类 号：R6[医药卫生—外科学]