完全机器人胃底折叠术21例的临床应用分析

Totally robotic fundoplication for the treatment of gastroesophageal reflux in 21 cases

目的评估完全机器人胃底折叠术的安全性和有效性.方法回顾性分析2023年8月至2024年1月昆明医科大学附属延安医院普外二科21例胃食管反流病患者的临床资料,总结完全机器人胃底折叠的手术方法及技巧,分析术中机器人及患者围手术期相关数据,应用SF-36健康调查简表(SF-36)、胃食管反流病自测量表(GERD-Q)、数字评定量表(NRS)评分指标评估术后效果.结果21例患者均手术成功,平均机器人手术时间(99±41)min,术中解剖精细,出血量仅为(1.7±1.4)ml,术中及术后均无并发症发生,无中转开腹.患者术后平均肠功能恢复时间为(11.71±3.33)h,术后疼痛NRS评分(1.67±0.48)分,术后住院时间为(3.86±2.90)d,术后患者满意度高,SF-36评分为(80.90±1.14)分.术后反流症状明显缓解,GERD-Q评分[(4.38±1.69)分]较术前的[(13.90±2.07)分]明显降低,差异有统计学意义,P<0.01.结论完全机器人胃底折叠术的术中解剖结构清晰,术后恢复快、疼痛轻,抗反流效果好.

Objective To evaluate the safety and effectiveness for the treatment of totally robotic fundoplication.Methods A retrospective analysis was conducted on the clinical data of 21 patients with gastroesophageal reflux disease(GERD)who underwent unassisted totally robotic fundoplication at the Second Department of General Surgery,Yan'an Hospital Affiliated to Kunming Medical University from Aug 2023 to Jan 2024.The postoperative outcomes were evaluated using SF-36,GERD-Q,and NRS scoring indicators.Results All 21 patients successfully underwent the surgery.The robotic surgery time was(99±41)minutes,with precise intraoperative anatomy and insignificant blood loss of(1.7±1.4)ml.There were no intraoperative or postoperative complications,and no conversions to open surgery.Postoperative recovery of bowel function was rapid(11.71±3.33)hours,with minimal postoperative pain(NRS score of 1.67+0.48).The postoperative hospital stay was short(3.86±2.90)days,and patient satisfaction was high,SF-36 score of(80.90±1.14);The symptoms of reflux after surgery was significantly reduced.Postoperative GERD-Q score of(4.38±1.69)significantly lower than the preoperative score of(13.90+2.07).Conclusion Totally robotic fundoplication provides clear view of intraoperative anatomical structures,rapid postoperative recovery,minimal pain,and effective anti-reflux outcomes.