达芬奇机器人与腹腔镜保脾胰体尾切除术近期临床疗效分析

Comparative analysis of clinical short-term outcomes of Da Vinci robot-assisted spleen-preserving distal pancreatectomy and laparoscopic spleen-preserving distal pancreatectomy

目的 对比达芬奇机器人下胰体尾切除术与腹腔镜下胰体尾切除术的近期临床疗效,总结达芬奇机器人在保留脾的胰体尾切除术中的临床应用经验.方法 回顾性分析青岛大学附属医院2013年3月-2015年6月行达芬奇机器人胰体尾切除术的12例患者与同期行腹腔镜胰体尾切除术的22例患者的临床资料,对比两组患者的手术及术后情况.结果 达芬奇机器人胰体尾切除术组术中出血量、术后住院时间及术后禁食时间少于腹腔镜胰体尾切除术组,达芬奇机器人胰体尾切除术组保脾率和住院费用高于腹腔镜胰体尾切除术组,差异具有统计学意义（p＜0.05）;两组手术时间及术后并发症发病率差异无统计学意义（P＞0.05）.术后随访l ～ 28个月,平均（9.94±8.99）个月,达芬奇机器人胰体尾切除术组腹腔感染1例,腹腔镜胰体尾切除术组腹腔脓肿3例,仅1例复发带瘤生存.其余所有患者均恢复良好.结论 达芬奇机器人胰体尾切除术安全可行,短期疗效优于腹腔镜胰体尾切除术,具有三维视野、操作灵活、创伤小和恢复快等优势,值得临床进一步推广应用.

Objective To compare the clinical result of Da Vinci robot-assisted distal pancreatectomy（RDP） and laparoscopic distal pancreatectomy（LDP）, and to evaluate the clinical application experience of Da Vinci robotassisted spleen-preserving distal pancreatectomy.Methods From March 2013 to June 2015, totally 12 patients undergone RDP and 22 patients undergone LDP in our department were analyzed retrospectively.Results Intraoperative blood loss, hospitalization duration and postoperative fast time in RDP group was less than that in LDP group, the spleen-preserving rate and hospitalization expenses were higher in RDP group（P ＜ 0.05）.There was no statistically significant difference in the rate of surgery duration and incidence of postoperative complication between two groups （P ＞ 0.05）.The following-up period was 1-28 months with a mean of （9.94 ± 8.99） months, 1 case of peritoneal infection occurred in RDP group, 1 case of survival with tumor recurrence and 3 case suffered peritoneal infection in LDP group.Others were no metastasis, recurrence or death.Conclusions RDP is safe and feasible, the short-term prognosis is better than that of LDP.It has advantages of cleat 3 D visual field, stability in control,less invasive,and quick recovery.It is worth further clinical use.