达芬奇机器人食管裂孔疝修补术临床疗效分析

Clinical effect analysis of Da-vinci robotic repair of hiatal hernia

目的总结分析10例达芬奇机器人食管裂孔疝修补术临床疗效和近期生活质量。方法纳入2016年4月至2019年6月,由西安交通大学第一附属医院胸外科所行达芬奇机器人食管裂孔疝修补术患者共10例。其中,男性6例,女性4例,年龄范围37~71岁,平均为(60.6±9.5)岁,身体质量指数(BMI)平均为(28.5±1.5)kg/m^2。分析临床特征及手术指标、术后主要并发症情况,应用消化病生存质量指数(GLQI)量表评估患者术后3个月及术后6个月的生活质量。计量资料以均数±标准差(x^ˉ±s)表示;GLQI评分数据两两比较采用t检验。以P<0.05认为差异有统计学意义。结果手术时间(141.8±20.2)min;术中出血量(64.0±24.5)mL;术后经口进食时间(3.6±1.1)d;术后住院时间(3.7±1.8)d。术前、术后3个月及术后6个月GLQI评分分别为(93±7.8)、(124±8.8)、(127±7.66);术后3个月和6个月得分均高于术前,差异有统计学意义(P<0.05);而术后3个月和6个月得分差异无统计学意义(P>0.05)。结论机器人食管裂孔疝修补术是安全可行的手术方式。对近期生活质量改善较好,在精细解剖和精准缝合具有明显优势,值得推广应用。

Objective To summary and analyze clinical effect and shortterm quality of life for 10 case of Davinci robotic repair of hiatal hernia.Methods Selected 10 patients between April 2016 and June 2019,who accepted Davinci robotic repair of hiatal hernia in thoracic department of the First Affiliated Hospital of Xi'an Jiaotong University,6 case of male and 4 of female.The average age was(60.6±9.5)years,and the average body mass index(BMI)was(28.5±1.5)kg/m^2,to analysize clinical characteristics、postoperation outcomes、complications and using the quality of life index(GLQI)to evaluate the quality of life of 3 months and 6 months postoperative.The measurement data were expressed as mean±standard deviation(x^ˉ±s).The t test was used for pairwise comparison of GLQI score data.P<0.05 was considered statistically significant.Results Surgical time:141.8±20.2min;Blood lose:64±24.5 mL;Time to eat:3.6±1.1d;Postoperation stay:3.7±1.8d.The GLQI score of preoperative,3 months postoperative and 6 months were 93±7.8,124±8.8,127±7.66 respectively.The scores of 3 and 6 months postoperative were higher than that of preoperative,and the difference was statistically significant(P<0.05).However,there was no significant difference in scores between 3 and 6 months postoperative(P>0.05).Conclusion Davinci robotic repaire of hiatal hernia is a safe and feasible operation,may improve shortterm quality of life,especially has advantages in fine anatomy and precise suture,worth of application.