机器人辅助腹腔镜妇科手术的安全性及可行性分析

Safety and feasibility analysis of robot-assisted laparoscopic gynecological surgery

目的探讨机器人辅助腹腔镜手术在妇科良恶性疾病中的安全性及可行性。方法回顾性分析2016年2月至2021年1月于重庆医科大学附属第一医院妇科行机器人辅助腹腔镜手术患者的临床资料、围手术期情况及近期疗效。结果1000例机器人辅助腹腔镜手术均顺利完成,无中转开腹。其中恶性肿瘤881例(88.10%),良性疾病119例(11.90%)。663例子宫颈癌患者平均手术时间(139.62±42.44)min,平均出血量(82.53±74.13)mL。163例子宫内膜癌患者平均手术时间(131.35±33.84)min,平均出血量(60.58±27.37)mL。41例卵巢癌患者平均手术时间(168.49±42.37)min,平均出血量(85.16±42.83)mL。术中并发症3例(0.3%),包括肠损伤1例,输尿管损伤2例;Clavien-DindoⅢ级及以上术后并发症14例(1.40%)。结论机器人辅助腹腔镜手术治疗妇科疾病是安全、可行的。

Objective To explore the safety and feasibility of robot-assisted laparoscopic surgery in malignant and benign gynecologic diseases.MethodsWe retrospectively reviewed the clinical data,peri-operative status and the short-term effects of patients with malignant and benign gynecologic diseases who underwent robot-assisted laparoscopic surgery in the First Affiliated Hospital of Chongqing Medical University from February 2016 to January 2021.Results A total of 1000 robot-assisted laparoscopic surgeries were completed without conversion.There were 881 cases(88.10%)of gynecologic malignancies and 119 cases(11.90%)of benign diseases.The mean operation time[(139.62±42.44)min]and mean blood loss[(82.53±74.13)m L]were observed in 663 patients with cervical cancer.The meanoperation time was(131.35±33.84)minutes and the mean blood loss was(60.58±27.37)m L in 163 patients withendometrial cancer.The 41 patients with ovarian cancer had a mean operation time of(168.49±42.37)minutes and amean blood loss of(85.16±42.83)m L.There were 3 cases(0.3%)of intraoperative complications,including 1 case ofintestinal injury and 2 cases of ureteral injury,and 14 cases(1.40%)of Clavien-Dindo gradeⅢand above postoperative complications.Conclusion Robot-assisted laparoscopic surgery for gynecological diseases is safe and feasible.