达芬奇机器人Si系统与Xi系统在经口腔前庭入路甲状腺手术中的对比分析

Application of different robotic systems in transoral robotic thyroidectomy vestibular approach:comparison between the Da Vinci Si and Xi

目的:探讨达芬奇机器人Si系统与Xi系统在经口腔前庭入路机器人甲状腺手术(Transoral robotic thyroidectomy,TORT)中的应用差异及术后结果对比分析。方法:回顾分析接受经口腔前庭入路机器人辅助下甲状腺手术的患者资料,共纳入患者59例,根据机器人操作系统的差别分为Si系统组和Xi系统组(其中Si系统组36例患者,Xi系统组23例患者),并对围手术期结果进行分析。结果:Si系统组的术后住院天数高于Xi系统组[(2.50±0.91)d Vs(2.08±0.29)d,P=0.015],Si系统组术后第1d的疼痛评分高于Xi系统组[(2.19±0.47)分Vs(1.87±0.46)分,P=0.011)],差异具有统计学意义;两组之间甲状旁腺功能一过性减退的发生率无显著差异,无患者出现永久性甲状旁腺功能减退;Si系统组中一过性颏神经麻痹患者9例,Xi系统组中未见一过性颏神经麻痹。结论:达芬奇机器人Si系统与Xi系统均可安全实施经口腔前庭入路机器人甲状腺手术,Xi系统可能更优。

Objective:To investigate the differences between Da Vinci robotic systems Si and Xi in transoral robotic thyroidectomy(TORT)vestibular approach and analyze the postoperative outcomes.Methods:The data of patients who underwent robotic thyroid surgery via transoral vestibular approach was reviewed.Patients were divided into two groups based on different robotic surgical systems(Da Vinci Si and Da Vinci Xi)and the perioperative outcomes were analyzed.A total of 59 patients were included,among which,36 patients in Si Group and 23 patients in Xi group.Results:Si Group had higher postoperative hospitalization days than Xi group[(2.50±0.91)d Vs(2.08±0.29)d,P=0.015],and higher pain score on the first day after surgery in Si group than Xi group[(2.19±0.47)Vs(1.87±0.46),P=0.011)],which was statistically different.The incidence of transient hypoparathyroidism was not significantly different between the two groups,and no patients developed permanent hypoparathyroidism.9 patients presented with transient submental nerve palsy in the Si Group and none in the Xi group.Conclusion:Oral vestibular thyroidectomy could be safely performed by both the Da Vinci robotic Si system and Xi system,and the Xi system may be superior.