达芬奇机器人辅助下单孔与多孔腹腔镜手术治疗早期子宫内膜癌的疗效对比  

Comparison of clinical efficacy of Da Vinci robot-assisted single-port and multi-port laparoscopic surgery in the treatment of early-stage endometrial cancer

作　　者：张琦玲 张智[1] 杨蕾[1] 蔡丽萍[1] ZHANG Qiling;ZHANG Zhi;YANG Lei;CAI Liping(Department of Gynecologic Oncology,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院妇产科,江西南昌330000

出　　处：《机器人外科学杂志（中英文）》2024年第3期319-326,共8页Chinese Journal of Robotic Surgery

基　　金：江西省自然科学基金项目(20192ACBL20038)。

摘　　要：目的:对比分析达芬奇机器人辅助下单孔和多孔腹腔镜手术治疗早期子宫内膜癌的安全性及临床价值。方法:回顾性分析2019年6月—2020年6月南昌大学第一附属医院收治的早期子宫内膜癌患者51例,其中达芬奇机器人辅助下单孔腹腔镜手术23例(机器人单孔组),多孔腹腔镜手术28例(机器人多孔组)。比较两组患者的基线特征、手术出血量、手术时间、淋巴结清扫数、术中转开腹率、术中输血情况、术中脏器损伤情况、术后排气时间、术后并发症、术后疼痛评分、总住院时间及随访患者对切口主观评价。结果:两组患者手术均顺利完成,未出现术中并发症,均未中转开腹或普通腹腔镜手术。两组术中均未输血,无术后并发症发生。机器人单孔组的手术时间长于机器人多孔组,术后排气时间短于机器人多孔组,术后疼痛评分低于机器人多孔组,总住院天数低于机器人多孔组,非常满意率分别为73.91%(17/23)和42.86%(12/28),差异均有统计学意义(P<0.05)。两组手术出血量、淋巴结清扫数目相比均无明显差异(P>0.05)。结论:达芬奇机器人辅助下单孔腹腔镜手术治疗早期子宫内膜癌是安全可行的。相比于达芬奇机器人辅助下多孔腹腔镜手术,机器人辅助下单孔腹腔镜手术具有术后排气时间短、住院时间短、疼痛评分低、切口美观、术后患者满意度高等优势。Objective:To explore the safety and clinical efficacy of Da Vinci robot-assisted single-port laparoscopic surgery in the treatment of early-stage endometrial cancer.Methods:Clinical data of 51 patients with early-stage endometrial cancer in the First Affiliated Hospital of Nanchang University from June 2019 to June 2020 were retrospectively analyzed.Patients who underwent Da Vinci robot-assisted single-port laparoscopic surgery were divided into the robot-assisted single-port laparoscopic group(n=23),and patients who underwent Da Vinci robot-assisted multi-port laparoscopic surgery into the robot-assisted multi-port laparoscopic group(n=28).The outcomes of the two groups were analyzed and compared,including the baseline characteristics,intraoperative blood loss,operative time,number of lymph node dissection,rate of conversion to laparotomy,intraoperative blood transfusion,intraoperative injury,postoperative exhaust time,postoperative complications,visual analogue scale(VAS),length of hospital stay and subjective evaluation of incision.Results:All surgeries were completed successfully without intraoperative or postoperative complications.No conversion to laparotomy or conventional laparoscopic surgery occurred.No blood transfusion performed during the operation.The operative time of the robot-assisted single-port laparoscopic group was longer than that of the robot-assisted multi-port laparoscopic group.The robot-assisted single-port laparoscopic group had a shorter postoperative exhaust time,lower VAS,and shorter length of hospital stay than the robot-assisted multi-port laparoscopic group.73.91%(17/23)of patients in the robot-assisted single-port laparoscopic group were very satisfied,compared with that 42.86%(12/28)of patients in the robot-assisted multi-port laparoscopic group,and all the differences were statistically significant(P<0.05).There was no significant difference in the amount of blood loss and the number of lymph node dissection between the two groups(P>0.05).Conclusion:Da Vinci robot-assisted sing

关 键 词：机器人辅助手术 单孔腹腔镜手术 多孔腹腔镜手术 子宫内膜癌 

分 类 号：R608[医药卫生—外科学] R713[医药卫生—临床医学] R737.3