机器人辅助腹腔镜下改良宫颈癌根治术的疗效分析  

Efficacy analysis of robot-assisted laparoscopic modified radical hysterectomy in the treatment of cervical cancer

作　　者：李贝 陈华[2] 张瑞琪 李茹月 马少寒 李博巍 祁馨仪 陈修鑫 哈春芳[2] LI Bei;CHEN Hua;ZHANG Ruiqi;LI Ruyue;MA Shaohan;LI Bowei;QI Xinyi;CHEN Xiuxin;HA Chunfang(The First Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Department of Gynecology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学第一临床医学院,宁夏银川750004 [2]宁夏医科大学总医院妇科,宁夏银川750004

出　　处：《机器人外科学杂志（中英文）》2024年第6期1077-1082,共6页Chinese Journal of Robotic Surgery

基　　金：宁夏回族自治区重点研发计划项目(2023BEG01001)。

摘　　要：目的:探讨机器人辅助腹腔镜下改良宫颈癌根治术在宫颈癌治疗中的优势与不足。方法:选取2021年4月—2023年10月行机器人辅助腹腔镜下改良宫颈癌根治术的100例IA2~IB2、ⅡA1期宫颈癌患者作为研究组,选取2019年9月—2021年3月行普通腹腔镜下改良宫颈癌根治术的120例IA2~IB2、ⅡA1期宫颈癌患者作为对照组,统计分析两组患者的一般资料、术中临床资料、术后临床资料、术后病理资料及术后近期并发症发生情况。结果:两组患者均顺利完成手术,术中均无中转开腹及重大周围脏器损伤。两组患者一般资料比较,差异无统计学意义(P>0.05)。两组患者术中临床资料中,与对照组相比,研究组手术时间更短,术中出血量更少,血管损伤率更低(P<0.05)。两组患者术后临床资料中,与对照组相比,研究组住院天数、通气时间、尿管拔除时间更短,术后12 h内视觉模拟评分法(Visual Analogue Scale,VAS)评分、抗生素升级率更低(P<0.05)。两组患者术后病理资料中,与对照组相比,研究组清扫淋巴结数目更多(P<0.05)。两组患者术后近期并发症发生率比较,差异无统计学差异(P>0.05)。结论:机器人辅助腹腔镜下改良宫颈癌根治术在宫颈癌手术治疗中具有手术时间短、术中出血量少、术后恢复快等特点,更符合根治性宫颈癌切除术的微创理念。Objective:To investigate the advantages and shortcomings of robot-assisted laparoscopic modified radical hysterectomy for cervical cancer in the treatment of cervical cancer.Methods:100 cases of IA2-IB2 and IIA1 stage cervical cancer patients who underwent robot-assisted laparoscopic modified radical hysterectomy for cervical cancer from April 2021 to October 2023 were selected into the study group,and 120 cases of IA2-IB2 and IIA1 stage cervical cancer patients who underwent ordinary laparoscopic radical hysterectomy from September 2019 to March 2021 were selected into the control group.The general data,intraoperative clinical data,postoperative clinical data,postoperative pathological data and the occurrence of short-term complications of the two groups were statistically analyzed.Results:Am surgeries were successfully completed,and there was no conversion to laparotomy or major peripheral organ injury.Comparing the general data of patients in the two groups,the difference was not statistically significant(P>0.05).Compared with the control group,the study group had a shorter operative time,less intraoperative bleeding and a lower rate of vascular injury(P<0.05).Compared with the control group,the study group had shorter length of hospita stay,exhaust time,urinary catheter removal time,and a lower Visual Analogue Scale(VAS)score and antibiotic escalation rate in the postoperative period of 12 h(P<0.05).In terms of the postoperative pathologic data of the two groups of patients,the number of dissected lymph nodes was higher in the study group than that in the control group(P<0.05).There was no statistical difference in the incidence of short-term complications between the two groups of patients(P>0.05).Conclusion:Robot-assisted laparoscopic modified radical hysterectomy for cervical cancer is characterized by shorter operative time,less intraoperative bleeding,and faster postoperative recovery,which is more in line with the minimally invasive concept of radical hysterectomy.

关 键 词：机器人辅助手术 腹腔镜手术 改良宫颈癌根治术 

分 类 号：R737.33[医药卫生—肿瘤]