机器人与腹腔镜子宫颈癌根治术的临床比较研究

Clinical Comparison of Robotic Versus Laparoscopic Radical Hysterectomy

目的:探讨机器人子宫颈癌根治术的安全性、可行性及优势。方法:回顾性分析2016年2月至2017年2月手术治疗的108例ⅠB1～ⅡA2期子宫颈癌患者的临床资料,分析、比较机器人子宫颈癌根治术(RRH组,n=50)与同期腹腔镜子宫颈癌根治术(LRH组,n=58)患者的手术时间、术中出血量、输血率、术后留置尿管时间、术后住院日、术后并发症及近期疗效等情况。结果:RRH组的手术时间短于LRH组(145.2±42.7分钟vs 160.7±28.5分钟)、术中出血量少于LRH组(93.8±42.6 ml vs 127.2±100.1 ml)、输血率低于LRH组(0 vs 12.1%)、术后留置尿管时间短于LRH组(13.9±5.5天vs 16.6±6.6天),差异均有统计学意义(P<0.05)。两组术中切除淋巴结数目、术后肛门排气时间、术后住院日、术后并发症及近期疗效比较,差异均无统计学意义(P>0.05)。结论:机器人子宫颈癌根治术安全可行,且具备手术时间短、术中出血少、输血率低、留置尿管时间短等优势。

Objective:To explore the feasibility,safety and advantages of robotic surgery system in the application of radical hysterectomy.Methods:A retrospective analysis was performed on the clinical data of 108 patients with FIGO stage Ⅰ B1 -Ⅱ A2 cervical cancer who underwent surgical treatment from February 2016 to February 2017.Total 50 cases of robotic radical hysterectomy(RRH group)and 58 cases of laparoscopic radical hysterectomy(LRH group)were involved.The operation duration,estimated blood loss,blood transfusion rate,postoperative urinary tube pull out time,postoperative hospital day,postoperative complications and short-term outcomes were analyzed and compared between the two groups.Results:Compared with the LRH group,the RRH group showed significantly shorter operation time,reduced blood loss,lower rate of blood transfusion,and shorter postoperative urinary tube pull out time(145.2±42.7 min vs 160.7±28.5 min,93.8±42.6 ml vs 127.2±100.1 ml, 0 vs 12.1%,13.9±5.5 d vs 16.6±6.6 d,respectively,P<0.05).The number of dissected lymph node,postoperative exhaustion time,postoperative hospital day,postoperative complications and short-term outcomes were similar in the two groups(P>0.05).Conclusions:Robotic radical hysterectomy is feasible and safe,with shorter operation time,less bleeding,lower rate of blood transfusion,and shorter postoperative urinary tube pull out time.