机器人手术系统、腹腔镜及开腹手术治疗宫颈癌的对比研究

A contrast analysis of robotic-assisted gynecological surgery,laparoscopy and open abdomen operation in the treatment of cervical cancer

目的：探讨机器人手术系统在宫颈癌手术中的安全性、可行性及其临床应用价值。方法回顾性分析2010年3月至2014年2月在第二炮兵总医院行宫颈癌根治术治疗的75例ⅠA～ⅡA期宫颈癌患者的临床资料，其中机器人（RRH）组23例、腹腔镜（LRH）组15例和开腹（ARH）组37例。结果 RRH组、LRH组及ARH组的出血量分别为（110.6±31.0）ml、（274.2±44.6）ml 和（1219.0±738.7）ml，输血量分别为（17±100）ml、（80±160）ml 和（1000±560）ml，手术并发症的发生率分别为8.6％（2/23）、20.0％（3/15）和48.6％（18/37），术后胃肠道的恢复时间分别为（33.2±17.0）h、（51.0±10.8）h 和（63.7±7.9）h。 RRH组与LRH组及ARH组比较，上述4项指标的差异均有统计学意义（P＜0.05）。结论在宫颈癌根治术中，机器人手术系统较腹腔镜和传统开腹术出血少、术后胃肠道恢复时间短及手术并发症低，提示机器人手术在宫颈癌治疗方面更具安全性、可行性和一定临床价值。

Objective To investigate the safety, feasibility and clinical application value of the robotic-assisted gynecological surgery in the treatment of cervical cancer. Methods A retrospective analysis was made on the clinical data of 75 cases of cervical cancer who undergoing radical hysterectomy at General Hospital of the Second Artillery between March 2010 and February 2014, inclu-ding 23 cases of cervical cancer undergoing robotic radical hysterectomy（RRH）, 15 cases of cervical cancer undergoing laparoscopic radical hysterectomy （ LRH ） and 37 cases of cervical cancer undergoing abdominal radical hysterectomy （ ARH ） . Results The operation blood loss was（110.6±31.0）ml,（274.2±44.6）ml and（1219.0±738.7）ml;volume of blood transfusion was（17±100）ml, （80±160）ml and（1000±560）ml; operative complications was 8.6%, 20.0% and 48.6% and postoperative anal exhaust time was （33.2±17.0）h,（51.0±10.8）h and（63.7±7.9）h in RRH, LRH and ARH group, respectively. The differences of the above indexes in RRH group was of statistical significance compared with LRH and ARH group（ P〈0.05） . Conclusion Robotic-assisted gynecologi-cal surgery in the treatment of cervical cancer is safe and feasible compared with laparoscopy and open abdomen operation. It has cer-tain clinical application value because of its advantages such as less operation blood loss and operative complications and shorter postop-erative anal exhaust time.