达芬奇机器人与腹腔镜胰体尾切除术近期临床疗效和安全性对比研究  

Comparison of short-term clinical efficacy and safety of robotic and laparoscopic distal pancreatectomy

作　　者：杨俊 肖奇贵 张曼[1] 仵正[1] 王铮[1] 黎韡 Yang Jun;Xiao Qigui;Zhang Man;Wu Zheng;Wang Zheng;Li Wei(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi′an Jiaotong University,Pancreatic center of Xi'an Jiaotong University,Xi′an 710061,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,西安交通大学胰腺疾病诊疗中心,西安710061

出　　处：《中华肝胆外科杂志》2024年第5期330-334,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：西安交通大学第一附属医院科研发展基金(2022MS-35)。

摘　　要：目的比较达芬奇机器人与腹腔镜行胰体尾切除的近期临床疗效和安全性。方法回顾分析西安交通大学第一附属医院肝胆外科2021年9月至2024年1月行胰体尾切除术的胰体尾占位性病变患者资料。共入组60例患者,其中男性20例,女性40例,年龄(52.0±14.8)岁。60例患者依据术式不同分为机器人组(n=30,行达芬奇机器人辅助胰体尾切除术)和腹腔镜组(n=30,行腹腔镜胰体尾切除术)。比较两组中转开腹、手术时间、术中出血量、保留脾脏、术后住院时间、术后禁食时间、术后30 d内再手术率、术后90 d内再入院率以及腹腔出血、腹腔感染、胰瘘等术后并发症。结果腹腔镜组无中转开腹,机器人组1例(3.3%)中转开腹。两组中转开腹、手术时间、术中出血量、术后住院时间、术后30 d内再手术率、术后90 d内再入院率等比较,差异均无统计学意义(均P>0.05)。机器人组保脾率为53.3%(16/30)、术后禁食时间为1.0(1.0,2.0)d,优于腹腔镜组的23.3%(7/30)、2.0(2.0,3.0)d,差异均有统计学意义(χ^(2)=5.71、Z=4.04,P=0.017、P<0.001)。腹腔镜组术后发生腹腔出血0例,腹腔感染6例(20.0%),B或C级胰瘘7例(23.3%),机器人组术后发生腹腔出血3例(10.0%),腹腔感染4例(13.3%),B或C级胰瘘8例(26.7%)。两组术后腹腔出血、腹腔感染、B或C级胰瘘发生率比较,差异均无统计学意义(均P>0.05)。结论胰体尾占位性病变患者行达芬奇机器人辅助胰体尾切除安全可行,保脾成功率优于腹腔镜胰体尾切除术。Objective To compare the short-term clinical efficacy and safety of Da Vinci robot and laparoscopic pancreatectomy.Methods The data of patients with pancreatic occupying lesions who underwent distal pancreatectomy in Department of Hepatobiliary Surgery,First Affiliated Hospital of Xi′an Jiaotong University from September 2021 to January 2024 were retrospectively analyzed.A total of 60 patients were enrolled,including 20 males and 40 females,aged(52.0±14.8)years.According to different operation methods,60 patients were divided into robotic group(n=30,Da Vinci robot-assisted pancreatectomy)and laparoscopic group(n=30,laparoscopic pancreatectomy).The conversion of laparotomy,operation time,intraoperative blood loss,splenic preservation,postoperative hospital stay,postoperative fasting time,reoperation rate within 30 days after surgery,readmission rate within 90 days after surgery,and postoperative complications such as abdominal hemorrhage,abdominal infection and pancreatic fistula were compared between the two groups.Results There was no conversion to laparotomy in the laparoscopic group,and 1 case(3.3%)in the robotic group.There were no significant differences in conversion to laparotomy rate,operation time,intraoperative blood loss,postoperative hospital stay,reoperation rate within 30 days after surgery,and readmission rate within 90 days after surgery between the two groups(all P>0.05).The spleen preservation rate of the robotic group was 53.3%(16/30),and the postoperative fasting time was 1.0(1.0,2.0)d,which was better than that of the laparoscopic group 23.3%(7/30),2.0(2.0,3.0)d,with statistical significance(χ^(2)=5.71,Z=4.04,P=0.017,P<0.001).Postoperative abdominal infection occurred in 6 cases(20.0%),grade B or C pancreatic fistula in 7 cases(23.3%),no abdominal hemorrhage in the laparoscopic group,postoperative abdominal hemorrhage in 3 cases(10.0%),abdominal infection in 4 cases(13.3%),and grade B or C pancreatic fistula in 8 cases(26.7%)in the robotic group.There was no significant difference in the

关 键 词：机器人手术 胰腺肿瘤 腹腔镜 外科手术 疗效 

分 类 号：R735.9[医药卫生—肿瘤]