机器人辅助腹腔镜胃间质瘤切除术的临床疗效分析

Clinical effect of robot-assisted laparoscopic resection for gastric stromal tumor

目的:分析机器人辅助腹腔镜胃间质瘤切除术的临床疗效。方法:回顾性分析齐齐哈尔市中医医院和漯河市中心医院2019年1月—2022年6月收治的125例行胃间质瘤切除术的患者临床资料。按手术方法分为两组,即机器人组(n=48)和腹腔镜组(n=77),机器人组行机器人辅助腹腔镜胃间质瘤切除术,腹腔镜组行腹腔镜下胃间质瘤切除术。对比两组患者手术效果、并发症及免疫炎症反应等。结果:机器人组手术时间、初次进食时间、胃肠减压管及腹腔引流管拔除时间短于腹腔镜组,差异有统计学意义(P<0.05),而比较两组患者术中出血量、消化道重建时间及住院时间,差异无统计学意义(P>0.05)。机器人组术中出现中转开腹率和肿瘤破裂率低于腹腔镜组,但差异无统计学意义(P>0.05)。比较机器人组与腹腔镜组术后并发症发生率及并发症严重分级,差异无统计学意义(P>0.05)。机器人组术后免疫功能高于腹腔镜组,炎症反应低于腹腔镜组,差异有统计学意义(P<0.05)。结论:与腹腔镜手术相比,机器人辅助腹腔镜胃间质瘤切除术能够缩短手术操作时间,减少并发症,减轻手术对患者免疫功能的影响,临床值得应用。

Objective:To analyze the clinical effect of robot-assisted laparoscopic resection for gastric stromal tumor.Methods:The clinical data of 125 patients who underwent gastric stromal tumor resection in Qiqihar Hospital of Traditional Chinese Medicine and Luohe Central Hospital from January 2019 to June 2022 were retrospectively analyzed.They were divided into the robotic group(n=48)and the laparoscopic group(n=77)according to the surgical method.The operative effect,complications and immune indexes were compared between the two groups of patients.Results:The operative time,first feeding time,gastrointestinal decompression tube and abdominal drainage tube removal time of the robotic group were shorter than those of the laparoscopic group,and the differences were statistically significant(P<0.05),while the differences in intraoperative blood loss,digestive tract reconstruction time and hospital stay between the two groups were not statistically significant(P>0.05).The rates of conversion to laparotomy and tumor rupture in the robotic group were lower than those in the laparoscopic group,and the differences were not statistically significant(P>0.05).There was no significant difference in the incidence and severity of postoperative complications between the two groups(P>0.05).The immune function of the robotic group was higher than that of the laparoscopic group,and the inflammatory response indicators were lower than that of the laparoscopic group,the differences were statistically significant(P<0.05).Conclusion:Compared with laparoscopic surgery,robot-assisted laparoscopic gastric stromal tumor resection could shorten the operative time,reduce complications,and lower the impact of surgery on patients’immune function,which is worthy of clinical application.