机器人与传统腹腔镜骶骨阴道固定术在超重/肥胖POP患者中的短期疗效对比  

Comparison of Short-Term Efficacy between Robotic-Assisted and Traditional Laparoscopic Sacrocolpopexy in Overweight and Obese Patients with Pelvic Organ Prolapse

作　　者：曾浩然 纪妹[1] 赵曌[1] 许鹏琳 何南南[1] 李悦[1] 张佳慧 ZENG Haoran;JI Mei;ZHAO Zhao(Department of Gynecology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学第一附属医院妇科,河南郑州450000

出　　处：《实用妇产科杂志》2024年第10期805-810,共6页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:通过比较机器人辅助腹腔镜骶骨阴道固定术(RASC)与传统腹腔镜骶骨阴道固定术(LSC)在超重/肥胖盆腔器官脱垂(POP)患者中的短期疗效,探讨机器人手术的优势。方法:回顾性分析2014年11月至2023年6月于郑州大学第一附属医院妇科实施骶骨阴道固定术的50岁以上超重/肥胖(体质量指数≥24 kg/m^(2))POP患者178例的临床资料,根据手术入路将其分为机器人组(68例)和腹腔镜组(110例)。比较两组的术中、术后及短期随访情况,采用盆底功能障碍问卷(PFID-20)、盆底障碍影响简易问卷(PFIQ-7)、盆腔器官脱垂术后患者全身状况改善问卷(PGI-I)评估手术效果。结果:①两组均无术中中转开腹病例。与腹腔镜组相比,机器人组手术时间短、术中出血量少、术后肛门排气时间短、术后住院时间短,差异均有统计学意义(P<0.05)。②机器人组未发生术中并发症,腹腔镜组术中有1例发生膀胱损伤。③两组组内比较,术后3月与术后12月的PFDI-20、PFIQ-7评分均低于术前,差异有统计学意义(P<0.05);PGI-I评分均为“明显改善”,主、客观治愈率为100%。④两组术后3月与术后12月的POP-Q指示点(Aa、Ba、C、Ap、Bp、gh、pb、TVL)均优于术前(P<0.05),获得满意的解剖学复位。结论:RASC治疗超重/肥胖POP患者安全可行,与LSC相比,手术时间更短、术中出血量更少、术后肠道功能恢复更快、术后住院时间更短,且短期疗效肯定,可成为超重/肥胖POP患者的新选择。Objective:To compare the short-term efficacy of robotic-assisted sacrocolpopexy(RASC)and laparoscopic sacrocolpopexy(LSC)in overweight/obese patients with pelvic organ prolapse(POP),and to evaluate the advantages of RASC.Methods:We retrospectively collected the clinical data of overweight/obese(body mass index≥24 kg/m^(2))patients over 50 years old with POP who underwent sacrocolpopexy in the Department of Gynecology of the First Affiliated Hospital of Zhengzhou University from November 2014 to June 2023.According to the surgical method,they were divided into robotic group(68 cases)and laparoscopic group(110 cases).The intraoperative,postoperative and short-term follow-up outcomes of the two groups were compared.Pelvic Floor Distress Inventory-short form 20(PFDI-20),Pelvic Floor Impact Questionnaire-short form 7(PFlQ-7)and the Patient Global Impression of Improvement(PGI-I)were used to evaluate surgical outcomes.Results:①No intraoperative conversion to laparotomy was found in both groups.Compared with the laparoscopic group,the robotic group had shorter operation time,less intraoperative blood loss,shorter postoperative anal exhaust time,and shorter postoperative hospital stay.The difference was statistically significant(P<0.05).②There were no intraopera-tive complications in the robot group.While in the laparoscopic group,there was 1 case of bladder injury.③Within the two groups,the PFDI-20 and PFIQ-7 scores at 3 and 12 months after surgery were lower than those before surgery,and the difference was statistically significant(P<0.05).PGI-I scores were both“significantly improved”.Subjective and objective cure rate were 100%.④The POP-Q indicator points(Aa,Ba,C,Ap,Bp,gh,pb,TVL)of both groups at 3 and 12 months after surgery were better than those before surgery(P<0.05),achieving satisfactory anatomical reduction.Conclusions:RASC is safe and feasible in the treatment of overweight and obese patients with POP.Compared to LSC,RASC has significantly shorter operation time,less blood loss,faster postoperat

关 键 词：盆腔器官脱垂 骶骨阴道固定术 机器人手术 腹腔镜手术 超重 肥胖 

分 类 号：R711.2[医药卫生—妇产科学]