达芬奇机器人手术与开放手术治疗甲状腺良性肿瘤的临床对照研究  

Clinical control study between Da Vinci robotic surgery and open surgery for the treatment of benign thyroid tumor

作　　者：宁鹏涛 刘宏斌 刘小南 NING Pengtao;LIU Hongbin;LIU Xiaonan(Ambulatory Surgery Center,the First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China;Department of General Surgery,Chang An Hospital)

机构地区：[1]空军军医大学第一附属医院西京医院日间手术中心,陕西西安710032 [2]长安医院普通外科

出　　处：《腹腔镜外科杂志》2025年第1期54-60,69,共8页Journal of Laparoscopic Surgery

基　　金：甘肃省武威市恶性肿瘤高发区防控模式示范;国家科技部、财政部惠民计划(2012GS620101)。

摘　　要：目的:探讨达芬奇机器人外科手术系统在甲状腺良性肿瘤手术中的应用价值,以期为达芬奇机器人手术系统在甲状腺手术中的应用与推广提供依据。方法:回顾性收集2018年1月至2019年12月收治的323例甲状腺良性肿瘤患者的临床资料,失访9例,最终纳入314例,其中69例行达芬奇机器人甲状腺切除术(RT),245例行开放甲状腺切除术(OT),对比分析两组手术相关指标。结果:两组患者基线资料差异无统计学意义(P>0.05)。与OT组相比,RT组手术切口小,术中出血量少,手术时间长,术后住院时间短,住院费用高,术后第1天、第2天疼痛程度重。术后第1天低钙血症发生率,甲状旁腺功能减退发生率,术后美容满意度评分,满意度评分,术后第1天、1周、3个月、6个月主观声音症状评分及术后第1天、1周、6个月主观吞咽症状评分低,差异有统计学意义(P<0.05);两组皮下气肿发生率、术后第3天疼痛评分、手术切口愈合情况、术后第1天伴低钙血症症状、永久性低钙血症发生率、术后第1天炎性反应指标(IL-6、降钙素原、C反应蛋白)、永久性甲状旁腺功能减退发生率差异无统计学意义(P>0.05)。结论:甲状腺良性肿瘤行达芬奇机器人手术安全、有效,具有较好的临床价值与发展前景。Objective:To explore the application value of the da Vinci robotic surgical system in the surgery of thyroid benign tumors,and provide evidence for the application and popularization of the da Vinci robotic surgical system in thyroid surgery.Methods:This study retrospectively reviewed a total of 323 patients with thyroid benign tumors admitted from Jan.2018 to Dec.2019.Among them,9 cases were lost to follow-up,and finally a total of 314 patients were included in this study.Among them,69 patients underwent da Vinci robotic thyroidectomy(RT),and 245 patients underwent open thyroidectomy(OT).The related indexes of the two groups were compared and analyzed.Results:There was no statistically significant difference in the baseline data between two groups(P>0.05).Compared with the OT group,the RT group had shorter surgical incisions,less intraoperative blood loss,longer surgical time,shorter postoperative hospital stay,higher hospitalization costs,more severe pain on the first and second day after surgery,lower incidences of hypocalcemia and hypoparathyroidism on the first day after surgery,lower cosmetic satisfaction scores and satisfaction scores(indicating higher satisfaction),lower subjective voice symptom scores on the first day,one week,three months,and six months after surgery(indicating milder symptoms),and lower subjective swallowing symptom scores on the first day,one week,and six months after surgery,and all these differences were statistically significant(P<0.05).There was no significant difference in the incidence of subcutaneous e mphysema,pain score on the third day after surgery,surgical incision healing,incidences of hypocalcemia symptoms on the first day a fter surgery and permanent hypocalcemia,inflammatory r esponse indicators(IL-6,procalcitonin,and C-reactive protein)on the first day after surgery and permanent hypoparathyroidism incidence between the two groups(P>0.05).Conclusions:The da Vinci robotic surgery for thyroid benign tumors is safe and effective,and has considerable clinical value and de

关 键 词：甲状腺良性肿瘤 甲状腺切除术 机器人手术 开放手术 对比研究 

分 类 号：R736.1[医药卫生—肿瘤]