达芬奇机器人甲状腺手术650例

Experience of 650 cases of thyroid surgery by da Vinci robot

目的探讨达芬奇机器人在甲状腺手术中的安全性、可靠性及美容效果。方法回顾性分析2014年2月～2018年4月解放军第九六○医院(原济南军区总医院)行机器人甲状腺手术650例患者的临床资料,并根据病理结果分为良性组和恶性组,分别统计两组肿瘤直径、淋巴结转移例数(恶性)、美容效果满意度,喉返神经损伤及甲状旁腺功能减退等。结果两组手术均顺利完成,无中转开放。两组均无永久性甲状旁腺功能减退,恶性组有1例永久性喉返神经损伤。①良性组共199例:手术平均时间为(97.87±14.02)分钟,术后平均引流液体量为(146.65±81.74)ml,术后平均住院时间为(5.76±1.75)天,暂时性喉返神经损伤2例,暂时性甲状旁腺功能减退19例。②恶性组共451例:Ⅵ、Ⅲ、Ⅳ组淋巴结转移率分别为46.56%(210/451)、41.17%(105/255)、29.41%(75/255);手术平均时间为(144.56±44.81)分钟,术后平均引流液体量为(231.21±90.04)ml,暂时性喉返神经损伤5例,暂时性甲状旁腺功能减退101例。结论达芬奇机器人甲状腺手术安全有效可靠,具有较好的美容效果。

OBJECTIVE To explore the treatment and cosmetic effect of da Vinci robot in thyroid surgery.METHODS The clinical data of 650 cases of robot thyroid surgery in the 960th Hospital of PLA(the formerly General Hospital of Jinan Military region) from February 2014 to April 2018 were analyzed retrospectively, and the pathological results were divided into benign group and malignant group respectively. The tumor diameter, lymph node metastasis cases (malignant), average time of operation, postoperative average drainage volume, average hospitalization time after operation, satisfaction of cosmetic effect, injury of recurrent laryngeal nerve and decrease of parathyroid function were recorded. RESULTS Both groups were successfully completed without open surgery. Both groups had no permanent hypoparathyroidism and one case of permanent laryngeal recurrent nerve injury in malignant group. 1. Benign group had 199 cases: the average time of operation was (97.87± 14.02) min, the average amount of drainage after operation was (146.65 ± 81.74) ml, average hospitalization time after operation was (5.76 ± 1.75) d;temporary recurrent laryngeal nerve injury in 2 cases, temporary parathyroid function decreased in 19 cases. 2. Malignant group had 451 cases: the lymph node metastasis rate of VI, ID and IV level were 46.56%(210/451), 41.17%(105/255), 29.41%(75/255), the average time of operation was (144.56±44.81) min, the average drainage fluid volume after operation was (231.21 ±90.04) ml, temporary recurrent laryngeal nerve injury in 5 cases, temporary parathyroid function decreased in 101 cases. CONCLUSION The da vinci robot thyroid surgery is safe, effective and reliable, and has better cosmetic effect.