机器人辅助腹腔镜下肾上腺肿瘤切除术与传统腹腔镜手术的疗效比较

Comparison of Curative Effect of Resection of Adrenal Tumor under the Robot Assisted Laparoscopy and Traditional Laparoscopic Surgery

目的分析比较机器人辅助腹腔镜下肾上腺肿瘤切除术与传统腹腔镜手术治疗肾上腺肿瘤的效果,并探讨机器人辅助腹腔镜下肾上腺肿瘤切除术的临床应用价值。方法收集重庆医科大学附属第一医院泌尿外科2016年4月—2017年5月收治的9例行机器人辅助腹腔镜下肾上腺肿瘤切除术的患者作为机器人手术组,以同期行腹腔镜肾上腺肿瘤切除术的20例患者为腹腔镜手术组,观察比较手术时间、术中出血量、术后引流管拔除时间、术后肠道功能恢复时间、术后并发症、术后住院时间以及随访肿瘤复发、血压、是否需长期口服激素情况。结果两组均成功完成手术,无一例中转开腹,机器人组与腹腔镜组在术中出血量、术后引流管拔除时间、术后肠道功能恢复时间、术后并发症、术后住院时间、术后随访结果的差异无统计学意义(P>0.05),机器人组的手术时间较腹腔镜组长[机器人组:(180±54)min,腹腔镜组:(139±64)min],差异有统计学意义(P<0.05),对于肿瘤直径≥4 cm的患者,机器人组与腹腔镜组在术后引流管拔除时间机器人组:(5.0±2.4)d,腹腔镜组:(2.6±1.1)d及术后住院时间机器人组:(9.3±2.6)d,腹腔镜组:(5.8±1.3)d的差异有统计学意义(P<0.05)。结论机器人辅助腹腔镜下肾上腺肿瘤切除术在手术时间上比腹腔镜肾上腺肿瘤切除术长,但在术中出血量、术后引流管拔除时间、术后肠道功能恢复时间、术后并发症、术后住院时间、术后随访结果方面与腹腔镜组差异无统计学意义。是治疗肾上腺肿瘤安全、有效的微创方式。

Objective To analyze and compare the effect of resection of adrenal tumor under theRobot assisted laparoscopy and traditional laparoscopic surgery and study the clinical application value of resection of adrenal tumor under theRobot assisted laparoscopy.postoperative drainage tube,recovery time of postoperative intestinal function,postoperative complications,postoperative length of stay,tumor recurrence at follow-up,blood pressure and oral administration of hormone for a long time or not were compared and observed.Results Both groups had successfully finished the operation,and the differences in the recovery time of postoperative intestinal function,postoperative complications,postoperative length of stay,tumor recurrence at follow-up,blood pressure between the two groups were not statistically significant(P>0.05),and the operation time in the robot group was longer than that in the laparoscopic group[(180±54)min vs(139±64)min],and the difference was statistically significant(P<0.05),and the differences in the postoperative drainage tube drawing time and postoperative length of stay of patients whose tumor diameter≥4 cm between the robot group and the laparoscopic group were statistically significant[(5.0±2.4),(9.3±2.6)d vs(2.6±1.1),(5.8±1.3)d](P<0.05).Conclusion The operation time of resection of adrenal tumor under the Robot assisted laparoscopy is longer than that of laparoscopic surgery,but there are no obvious differences in the intraoperative bleeding amount,postoperative drainage tube drawing time,recovery time of postoperative intestinal function,postoperative complications,postoperative length of stay,postoperative follow-up results between the two groups,and the resection of adrenal tumor under the robot assisted laparoscopy is a safe and effective minimal invasive way.