机器人辅助腹腔镜与传统腹腔镜在巨大子宫切除术的疗效比较  

Comparison of Robot Assisted Laparoscopy and Traditional Laparoscopy in Giant Hysterectomy

作　　者：张婷[1] 纪妹[1] 赵曌[1] 何南南[1] 李悦[1] 赵施旖 ZHANG Ting;JI Mei;ZHAO Zhao(Department of Gynecology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 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：《实用妇产科杂志》2023年第10期769-774,共6页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:比较达芬奇机器人子宫切除术(RH)与传统腹腔镜子宫切除术(TLH)在巨大子宫切除中的临床疗效,以探讨相关临床经验和机器人手术优势。方法:回顾性分析郑州大学第一附属医院2014年11月至2021年11月完成的因良性疾病导致的巨大子宫并接受RH或TLH共813例患者的临床资料。其中RH组374例、TLH组439例。对两组患者的一般资料、围手术期相关指标、近远期并发症情况进行比较,及其在大子宫人群(子宫体积为孕12~16周)和超大子宫人群(子宫体积大于孕16周)中相关指标的比较。结果:①与TLH组相比,虽然RH组子宫体积较大、腹部手术史发生率较高、手术时间较长;但术中出血量减少、术中输血率降低、术后肛门排气时间缩短、术后住院时间缩短,差异均有统计学意义(P<0.05)。两组均无术中转变手术方式的病例。近期术后并发症中,下肢静脉血栓形成发生率最高(3.20%,26/813),远期术后并发症中,淋巴潴留囊肿发生率最高(1.11%,9/813)。②在大子宫人群中,与TLH组相比,虽然RH组手术时间较长,但术中输血率降低、术后肛门排气时间缩短、术后住院时间缩短,差异有统计学意义(P<0.05)。③在超大子宫人群,与TLH组相比,RH组术后住院时间缩短(P<0.05),余各项围手术期指标比较差异均无统计学意义(P>0.05)。结论:机器人巨大子宫切除术是安全可行的,与传统腹腔镜相比,机器人辅助腹腔镜有术中出血量更少、术后肠道功能恢复更快等优势。此外,子宫体积的增大并未对手术并发症造成显著影响。Objective:To compare the clinical efficacy of Leonardo da Vinci robotic Hysterectomy(RH)and traditional laparoscopy Hysterectomy(TLH)in giant hysterectomy,so as to explore the relevant clinical experience and advantages of robotic surgery.Methods:The clinical data of 813 patients with giant uterus caused by benign diseases and receiving RH or TLH at First Affiliated Hospital of Zhengzhou University from Novemker 2014 to November 2021 were analysed retrospectively.Among them were 374 cases in the RH group and 439 cases in the TLH group.Compare the general information,perioperative related indicators,and perioperative indicators of two groups of patients in the large uterine population(uterine volume between 12-16 weeks of pregnancy)and the oversized uterine population(uterine volume>16 weeks of pregnancy).Results:①Compared with the TLH group,the RH group had larger uterine volume,higher incidence of abdominal surgery history,longer surgical time,less intraoperative bleeding,lower intraoperative blood transfusion rate,shorter postoperative anal exhaust time,and shorter postoperative hospital stay,with statistically significant differences(P<0.05).There were no cases of intraoperative changes in surgical methods in both groups.Among the recent postoperative complications,the incidence of lower limb venous thrombosis was the highest(3.20%,26/813).Among the long-term postoperative complications,the incidence of lymphatic retention cyst was the highest(1.11%,9/813).②In the large uterine population,compared with the TLH group,the RH group had longer surgical time,lower intraoperative blood transfusion rate,shorter postoperative anal exhaust time,and shorter postoperative hospital stay,with statistically significant differences(P<0.05).③In the oversized uterus population,compared with the TLH group,the RH group had a shorter postoperative hospitalization time,with a statistically significant difference(P<0.05).There was no statistically significant difference in other perioperative indicators(P>0.05).Conclusions:Ro

关 键 词：机器人手术 腹腔镜 巨大子宫 子宫切除 

分 类 号：R713.4[医药卫生—妇产科学]