达芬奇机器人系统在子宫肌瘤剔除术中的应用

Clinical Analysis of Da Vinci Robotic-Assisted Laparoscopic Myomectomy

目的:探讨达芬奇机器人系统在子宫肌瘤剔除术中应用的可行性。方法:回顾性分析郑州大学第一附属医院2016年1月—2017年12月收治的行子宫肌瘤剔除术患者的临床资料,其中机器人组18例、腹腔镜组27例。机器人组中包括2例阔韧带肌瘤和4例宫颈肌瘤,腹腔镜组中包括2例阔韧带肌瘤和5例宫颈肌瘤。分别比较2组围手术期相关指标。结果:机器人组手术时间长于腹腔镜组[(131.17±25.26)min vs.(104.30±24.43)min,P<0.05]。机器人组实际手术操作时间与腹腔镜组相比差异无统计学意义[(109.00±21.64)min vs.(104.30±24.43)min,P>0.05]。而机器人组在术中出血量、术后排气时间均优于腹腔镜组[(50.56±21.95)m L vs.(73.33±26.38)m L,(27.00±5.50)h vs.(33.33±5.14)h,P<0.05)]。2组术后住院时间差异并无统计学意义[(4.28±1.12)d vs.(5.00±1.24)d,P>0.05)]。对于特殊部位子宫肌瘤剔除术的比较,机器人组与腹腔镜组在手术时间、实际手术操作时间和术后住院时间差异均无统计学意义(P>0.05),机器人组术中出血量及术后排气时间小于腹腔镜组(P<0.05)。结论:机器人子宫肌瘤剔除术较腹腔镜手术有出血少、术后恢复快等优势,特别是在特殊部位的子宫肌瘤剔除术中。

Objective：To investigate the safety,feasibility of the Da Vinci robotic-assisted laparoscopic myomectomy.Methods：A retrospective analysis was made on the clinical data of 45 cases of myomectomy at First Affiliated Hospital of Zhengzhou University from January 2016 to December 2017,including 18 cases of the robotic group,27 cases of the laparoscopic group.The robotic group included 2 cases of broad ligament fibroids and 4 cases of cervical fibroids.The laparoscopic group included 2 cases of broad ligament fibroids and 5 cases of cervical fibroids.The clinical parameters were compared between the two groups.Results：The operation time in the robotic group （131.17±25.26） min was longer than that in the laparoscopic group （104.30±24.43） min （P＜ 0.05）.The difference of the actual operating times of the two groups [（109.00±21.64） min vs.（104.30±24.43） min] was not significant （P＞0.05）.The robotic group was superior to the laparoscopic group in terms of intraoperative blood loss [（50.56±21.95） mL vs.（73.33±26.38） mL] and postoperative exhaust time [（27.00±5.50） h vs.（33.33 ± 5.14） h] （P＜0.05）.There was no significant difference in the postoperative hospital stay between the two groups [（4.28±1.12） d vs.（5.00±1.24） d] （P＞0.05）.As for the myomectomy in the special parts of uterus,there were no significant differences in the operation time,actual operating time and postoperative hospital stay between the two groups （all P＞0.05）.The robotic groups had less intraoperative blood loss and shorter postoperative exhaust time （P ＜0.05）.Conclusions：Compared with laparoscopic surgery,the Da Vinci robotic-assisted laparoscopic myomectomy has the advantages of less bleeding and faster postoperative recovery,especially in myomectomy in the special parts of uterus.