机器人与腹腔镜食管裂孔疝修补术联合Nissen胃底折叠术短期疗效分析  

An analysis of short-term outcomes of robotic-assisted versus conventional laparoscopic esophageal hiatal hernia repair combined with nissen fundoplication

作　　者：李义亮[1,2,3] 苏拉依曼·牙库甫 麦麦提艾力·麦麦提明 克力木·阿不都热依木 Yiliang Li;Yakufu Sulayiman;Maimaitiming Maimaitiaili;Abudoureyimu Kelimu(Department of Minimally Invasive Surgery,Hernias and Abdominal Wall Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830002,China;Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery,Xinjiang Uygur Autonomous Region,Urumqi 830002,China;Research Institute of General and Minimally Invasive Surgery,Xinjiang Uygur Autonomous Region,Urumqi 830002,China)

机构地区：[1]新疆维吾尔自治区人民医院微创、疝和腹壁外科,乌鲁木齐830002 [2]新疆胃食管反流病与减重代谢外科临床医学研究中心,乌鲁木齐830002 [3]新疆维吾尔自治区普外微创研究所,乌鲁木齐830002

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第5期512-517,共6页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的比较机器人辅助与传统腹腔镜食管裂孔疝修补术(HHR)联合Nissen胃底折叠术的临床疗效,探讨机器人辅助系统应用的安全性及可行性。方法回顾性分析2022年4月至2023年4月新疆维吾尔自治区人民医院微创、疝和腹壁外科155例行HHR联合Nissen胃底折叠术患者的临床资料,根据手术方案不同分为机器人组及腹腔镜组,其中机器人组59例,腹腔镜组96例,比较2组患者围手术期相关临床指标、术后住院时间、手术前后相关症状改善情况。结果所有患者均顺利完成手术,无中转开腹或改变术式,无手术相关严重并发症发生。2组患者在年龄、性别、体重指数、术前质子泵抑制剂服用时间、术前高分辨率食管测压、术前检验指标等方面差异均无统计学意义(P>0.05);机器人组与腹腔镜组手术时间相当[2(1.00)h比2(0.98)h],差异无统计学意义(Z=-0.62,P=0.532)。机器人组较腹腔镜组术中出血量少[(25.32±2.59)ml比(39.74±4.92)ml,t=23.84,P<0.001]、术后住院时间短[4(2.75)d比5(3.00)d,Z=-3.18,P=0.001],差异均有统计学意义。2组均无30 d内再入院病例,差异无统计学意义(Z=-1.36,P=0.172)。结论机器人辅助较腹腔镜HHR联合Nissen胃底折叠术,术中出血量少,创伤小,住院时间短,近期效果良好。Objective To compare the clinical efficacy of robotic-assisted and conventional laparoscopic esophageal hiatal hernia repair combined with Nissen fundoplication,and to explore the safety and feasibility of applying a robotic-assisted system.Methods We retrospectively analyzed the clinical data of 155 patients who underwent esophageal hiatal hernia repair combined with Nissen fundoplication in the Minimally Invasive,Hernia and Abdominal Wall Surgery Department of the Xinjiang Uygur Autonomous Region People&apos;s Hospital from April 2022 to April 2023,and divided them into robotic and laparoscopic groups according to the surgical protocols,of which 59 cases were in the robotic group and 96 cases were in the laparoscopic group.We compared the perioperative clinical indicators,postoperative hospitalization time,and improvement of symptoms before and after surgery.Results All patients successfully completed the surgery,without intermediate open or change of operation,and no serious complications related to surgery occurred.The differences between the two groups in age,gender,body mass index,preoperative proton pump inhibitor taking time,preoperative high-resolution esophageal manometry,and preoperative test indexes were not statistically significant(P>0.05);the surgical operation time of the robotic group and the laparoscopic group were comparable[2(1.00)h than 2(0.98)h],the difference was not statistically significant(Z=-0.62,P=0.532).The robotic group had less intraoperative bleeding[(25.32±2.59)ml than(39.74±4.92)ml,t=23.84,P<0.001]and shorter postoperative hospitalization[4(2.75)d than 5(3.00)d,Z=-3.18,P=0.001]than the laparoscopic group,and the differences were statistically significant.2 groups did not have any readmission cases within 30 d,the difference was not statistically significant(Z=-1.36,P=0.172).Conclusion Compared with laparoscopic esophageal hiatal hernia repair combined with Nissen fundoplication,robot-assisted repair has less intraoperative bleeding,less trauma,shorter hospitalization time,and g

关 键 词：疝 食管裂孔 人工智能 机器人辅助手术 胃底折叠术 临床疗效 

分 类 号：R655.4[医药卫生—外科学]