机器人与腹腔镜治疗子宫内膜癌短期疗效对比

The short-term treatment of robotic-assisted surgery versus laparoscopic surgery in endometrial cancer

目的通过比较机器人手术与腹腔镜手术治疗子宫内膜癌(endometrial cancer,EC)的短期疗效,探讨机器人手术治疗EC的临床优势。方法回顾性分析甘肃省人民医院2014年1月至2017年10月完成的108例EC患者的临床资料。其中机器人组52例、腹腔镜组56例。采用多元线性回归分析比较两组的手术时间、淋巴结清扫数目、住院时间、术中出血量的差异,采用多元Logistic回归分析比较两组转入ICU率的差异。结果多元线性回归分析中,机器人组、腹腔镜组的手术时间、住院时间、术中出血量、中转开腹率比较,差异均无统计学意义(P> 0. 05),但机器人组淋巴结清扫数目明显多于腹腔镜组(Coe.=13. 25,95%CI:8. 30～18. 21,P <0. 05)。多元Logistic回归分析中,两组间转入ICU率比较,差异无统计学意义(P> 0. 05)。结论机器人手术治疗EC与传统腹腔镜手术短期疗效相似,并且在淋巴结清扫方面达芬奇机器人具有明显的优势。

Objective The aim of this study was to compare short- term treatment between robotic- assisted versus laparoscopic surgery in patients with endometrial cancer, discuss the clinical advantages of robotic- assisted surgery in endometrial cancer. Methods The clinical data of 108 patients with endometrial from Jan. 2014 to Oct. 2017 in Gansu Provincial Hospital were retrospectively analyzed. There were 52 cases in robotic- assisted surgery group （RS） and 56 cases in laparoscopic surgery group （LS）. Multivariable linear regressions were used to explore the difference between the RS and LS in terms of the operation time, estimated blood loss, length of hospital stay, lymph node counts. Multivariate Logistic regression model was used to evaluate the difference of transfer to ICU. Results In multivariable linear regressions, there was no significant difference in operative time, estimated blood loss, length of hospital stay（ P 〉0.05）. However, the counts of lymph node in RS were significant increased compared to LS （ Coe .=13.25, 95% CI ：8.30- 18.21, P 〈0.05）. In multivariate Logistic regression, there was no difference in the rate of transfer to ICU between two groups（ P 〉0.05）. Conclusions Robotic- assisted surgery has a comparable clinical benefit as laparoscopic surgery and provides an advantage in lymph node dissection.