达芬奇机器人宫颈癌根治术24例临床分析

Clinical analysis of 24 cases of robotic-assisted radical hysterectomy

目的探讨达芬奇机器人宫颈癌根治术的安全性、可行性及临床应用价值。方法回顾性总结吉林省肿瘤医院于2014年10月至2016年10月的24例(宫颈癌ⅠA2-ⅡA2期)达芬奇机器人宫颈癌根治术的临床资料及治疗效果。结果 24例手术均顺利完成,无中转开腹及更改术式;其中1例保留生育功能,7例保留盆腔神经;手术时间135~280 min,平均(166.7±16.5)min;术中出血量35~95 ml,平均(66.1±12.5)ml;术后膀胱功能恢复时间(拔除导尿管后测定残余尿小于100 ml,可自行排尿)164~356 h,平均(224.7±15.9)h;切除淋巴结(盆腔、腹主动脉旁)数17~38枚,平均(31.4±5.7)枚;住院时间91~361 h,平均(168.7±12.5)h。结论达芬奇机器人宫颈癌根治术安全、可行,患者创伤小、恢复快,安全性高,具有临床应用价值。

Objective To explore the safety ,feasibility and clinical of Da Vinci robot surgical sysem for radical hysterectomy. Methods Retrospective summary the clinical data and therapeutic effect of 24 cases （ cervical cancer Ⅰ A2- Ⅱ A2 ） Da Vinci robotic surgery system of radical hysterectomy from Jilin province tumor hospital from Oct. 2014 to Oct. 2016. Results 24 cases were successfully completed surgery, no transfer laparotomy and change. 1 case fertility-sparing surgery, 7 cases pelvic nerve preservation. The operation Lime 135-280 min, the average time （ 166.7 ± 16.5） rain; intraoperative blood loss 35-95 ml, on average （168.4 ± 141.9）ml; the recovery time of bladder function（ postoperative residual urine less than 100 ml,spontaneous voiding ）164-356 h, the average time （224.7 ±15.9） h ;the number of lymph nodes 17-38, on average （31.4± 5.7） ; length of hospitalization 91-361 h , the average time （ 168.7 ± 12.5 ） h. Conclusions Da Vinci robotic surgical operating system applied in radical hysterectomy is safe , feasible , patients trauma with small, fast recovery, worthy of clinical popularization and application.