宫底悬吊免举宫技术辅助应用于早期宫颈癌达芬奇机器人系统手术效果

Clinical effect of the lift-free technique as auxiliary measure used in early-stage cervical cancer surgery by Da Vinci robotic manipulator

目的:探讨宫底悬吊免举宫技术在早期宫颈癌手术中的安全性及有效性。方法:回顾性收集2018年1月-2019年11月就诊于本院妇科的宫颈癌(Ia2-IIa1期)患者119例,均采用达芬奇机器人系统行宫颈癌根治手术,按手术辅助方式分为举宫器组(58例)和免举宫组(61例)。观察两组手术时间、术后通气时间、术中出血量、术后48 h引流量、术后住院天数。结果:术中出血量、手术时间、术后通气时间两组无差异,两组术后均未出现并发症,术后48 h腹腔引流量免举宫组(480.7±176.7ml)少于举宫器组(416.6±257.4ml)(z=-2.372,P=0.018),术后住院时间(5.9±1.5d)短于举宫器组(8.9±2.8d)(z=-7.049,P<0.01)。结论:宫底悬吊免举宫技术辅助早期宫颈癌微创手术利于术后恢复且安全可行,其远期效果(复发率和生存期)仍需进一步观察。

Objective:To explore the safety and efficacy of the intrauterine suspension and lift-free technique in early cervical cancer surgery.Methods:119 patients with early cervical cancer(Ia2-IIa1 stage)from January 2018 to November 2019 were collected retrospectively.These patients were all given surgery by Da Vinci robotic manipulator.These patients were divided into two groups according to the surgical auxiliary methods,which included group A(58 cases were given lifting technique of uterus)and group(61 cases were given lift-free technique).The operation time,the postoperative ventilation time,the intraoperative blood loss,the drainage volume in postoperative 48-hour,and the postoperative hospital stay time of the patients were compared between the two groups.Results:There were no significant differences in the intraoperative blood loss,the operation time,and the postoperative ventilation time of the patients between the two groups.There was no any postoperative complication occurred in the two groups.The drainage volume in postoperative 48-hour(480.7±176.7ml)of the patients in group B was significantly less than that(416.6±257.4ml)of the patients in group A(z=-2.372,P=0.018),and the postoperative hospital stay time(5.9±1.5d)of the patients in group B was significantly shorter than that(8.9±2.8d)of the patients in group A(z=-7.049,P<0.01).Conclusion:The intrauterine suspension and lift-free technique as auxiliary measure used in minimally invasive surgery of early-stage cervical cancer is safe and feasible,but its long-term effects(recurrence rate and survival time)need to be further observed.