机器人辅助腹腔镜手术与传统后腹腔镜手术治疗肾上腺肿瘤的疗效比较

Comparison of clinical efficacy between robot-assisted laparoscopic adrenalectomy and conventional retroperitoneal laparoscopic adrenalectomy

目的：比较机器人辅助腹腔镜手术与传统后腹腔镜手术治疗肾上腺肿瘤的疗效。方法：分别选取2013年5月-2015年8月在我院接受机器人辅助腹腔镜手术与传统后腹腔镜手术治疗的肾上腺肿瘤患者23例（机器人组）和85例（传统组）,统计所有患者基本资料,比较两组患者的基本特征、围手术期资料、手术并发症和术后随访结果。结果：两组患者的年龄（P=0.7016）、体重指数（P=0.3098）,性别构成比（P=0.8146）以及手术部位（P=0.8171）的差异均无统计学意义,机器人组肿瘤直径较大（P=0.0126）,有腹部相关手术史患者的比例更高（P=0.0012）。术后引流时间（P=0.092）、术后第一次进食时间（P=0.8111）、术后住院天数（P=0.0276）的差异均无统计学意义。对于大于5cm肿瘤的患者,机器人组手术时间比传统组长（P=0.0361）,术中失血量（P=0.3449）、术后引流时间（P=0.5064）、术后进食时间（P=0.2 029）、术后住院天数（P=0.2771）的差异均无统计学意义。结论：机器人辅助腹腔镜肾上腺手术是安全、有效的,与传统腹腔镜肾上腺手术相比,在术中失血量、术后胃肠功能恢复情况以及术后随访结果方面的差异无统计学意义,可以达到同等的治疗效果。

Objective：To compare the clinical efficacy between robot-assisted laparoscopic adrenalectomy and conventional retroperitoneal laparoscopic adrenalectomy.Method：From May 2013 to August 2015 in our center 23 patients undergoing robot-assisted laparoscopic adrenalectomy and 85 patients receiving conventional retroperitoneal laparoscopic adrenalectomy were recruited in the study.The clinical data were collected and analyzed including basic characteristics,perioperative data,complications and follow-up results.Result：There was no significant difference between the two groups with regard to the age,BMI,sex constitution and surgical site.The cases in the robotic group have a larger adrenal tumor and higher proportion of patients with abdominal surgery history.There was no statistically significant difference in postoperative drainage duration,first oral-intake and postoperative hospital stay between two groups.For patients with large tumor（〉5cm）,operation time of conventional surgery was shorter,but intraoperative blood loss,postoperative drainage duration,first oral-intake and postoperative hospital stay showed no significant difference between two groups.Conclusion：Robot-assisted laparoscopic adrenalectomy is safe and feasible and can achieve equal therapeutic efficacy.The intraoperative blood loss,postoperative digestive function recovery and follow-up results in the robotic group were similar to those in conventional retroperitoneal laparoscopic group.