[1]王靖 姜蕾 郭天康 王海琳＊.达芬奇机器人、腹腔镜及开腹子宫内膜癌全面分期手术的比较[J].中国微创外科杂志,2018,18(11):974-977.
　Wang Jing,Jiang Lei,Guo Tiankang,et al.Comparison of da Vinci Robot, Laparoscopy, and Laparotomy for Endometrial Cancer in Comprehensive Staging Surgery[J].Chinese Journal of Minimally Invasive Surgery,2018,18(11):974-977.
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达芬奇机器人、腹腔镜及开腹子宫内膜癌全面分期手术的比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年11期
页码:
974-977
栏目:
临床论著
出版日期:
2018-11-20

文章信息/Info

Title:
Comparison of da Vinci Robot, Laparoscopy, and Laparotomy for Endometrial Cancer in Comprehensive Staging Surgery
作者:
王靖 姜蕾 郭天康 王海琳＊
（甘肃省人民医院妇产科，兰州730000）
Author(s):
Wang Jing;  Jiang Lei;  Guo Tiankang;  et al.
Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou 730000, China
关键词:
子宫内膜癌; 机器人手术系统; 腹腔镜手术; 开腹手术
Keywords:
Endometrial cancer; Robot surgical system; Laparoscopy; Laparotomy
文献标志码:
A
摘要:
目的探讨达芬奇机器人手术系统行早期子宫内膜癌全面分期手术的安全性、可行性及有效性。方法回顾性分析2015年2月~2017年10月子宫内膜癌全面分期手术105例资料，其中机器人组50例，腹腔镜组29例，开腹组26例。病灶局限于宫体（FIGO Ⅰ期）行全子宫及双附件切除+全面分期手术，病灶疑有或已有宫颈累及(FIGO Ⅱ期)行根治性全子宫及双附件切除+全面分期手术，比较3组手术时间、术中失血量、盆腔及腹主动脉旁淋巴结切除数目、术后肛门排气时间、尿管留置时间、并发症、住院时间、复发率等。结果3组手术时间、腹主动脉旁淋巴结切除数目无统计学差异(P＞005)。3组中机器人组出血量最少［（189.0±117.1）、（277.6±130.6）、（346.2±133.4）ml，F=12.147，P=0.000］，盆腔淋巴结切除数目最多［（29.2±8.4）、（22.7±9.7）、（20.1±7.0）枚，F=11.754，P=0.000］，肛门排气时间最早［(3.0±0.9)、(3.5±0.9)、(40±1.3)d，F=8.855，P=0.000］，尿管留置时间最短［(4.9±1.6)、(6.0±1.7)、(6.6±1.4)d，F=11.387，P=0.000］，并发症最少［10%(5/50)，27.6%（8/29）,42.3%(11/26), χ2=10.634，P=0.005］，术后住院时间最短［(8.3±20)、(9.9±31)、(11.9±3.2)d，F=15.746，P=0.000］。3组术后随访1~2年，机器人组2例复发（4%），腹腔镜及开腹组各1例（3.4%、3.8%），3组复发率无统计学差异(χ2=0.015，P=0.992)。结论与传统方法相比，应用机器人手术系统具有出血量少、盆腔淋巴结切除数目多、术后肛门排气时间及尿管留置时间短、并发症少、住院时间短等优势，疗效相当，提示机器人手术在子宫内膜癌治疗方面安全、可行、有效。
Abstract:
ObjectiveTo evaluate the safety, feasibility, and efficacy of the da Vinci Robot Surgical System in comprehensive staging surgery for early endometrial cancer.MethodsA retrospective analysis was made on the clinical data of 105 cases of endometrial cancer who underwent endometrial cancer comprehensive staging surgery. There were 50 patients in the robot group, 29 in the laparoscopic group, and 26 in the laparotomic group. For lesions confined to the uterine cavity (FIGO stage Ⅰ), total hysterectomy and double accessory resection with comprehensive staging surgery were performed. For lesions with or without cervical involvement (FIGO stage Ⅱ), radical hysterectomy and double accessory resection with comprehensive staging surgery were given. The operation time, intraoperative blood loss, number of resected pelvic and paraaortic lymphadenectomic nodes, postoperative exhaust time, indwelling catheter time, complications, hospital stay, and recurrence rate were compared among the three groups.ResultsThere were no significant differences in the operation time and paraaortic lymphadenectomic nodes among the 3 groups (P>0.05). Among the three groups, the robot group had the least amount of blood loss ［(189.0±117.1), (277.6±130.6), and (346.2±133.4) ml, F=12.147, P=0.000］, the largest number of nodes of pelvic lymphadenectomy ［(29.2±8.4), (22.7±97), and (20.1±7.0) nodes, F=11.754, P=0.000］, the earliest postoperative exhaust time ［(3.0±0.9), (3.5±0.9), and (4.0±1.3) d, F=8.855, P=0.000］, the shortest indwelling catheter time ［(4.9±1.6), (6.0±1.7), and (6.6±1.4) d, F=11.387, P=0.000］, the lowest complication rate ［10% (5/50), 27.6% (8/29), and 42.3% (11/26), χ2=10.634, P=0005］, and the shortest postoperative hospital stay ［(8.3±2.0), (9.9±3.1), and (11.9±3.2) d, F=15.746, P=0000］. The three groups were followed up for 1-2 years. Recurrence was found in 2 cases in the robot group (4%), 1 case in the laparoscopic group (3.4%) and 1 case in the laparotomic group (3.8%). No significant difference was found in the recurrence rate among the three groups (χ2=0.015, P=0.992).ConclusionsCompared to the traditional method, the da Vinci Robot Surgical System has the advantages of less blood, more pelvic lymphadenectomic nodes, shorter postoperative exhaust and indwelling catheter time, fewer complications and shorter hospital stay. With similar efficacy, it is a safe, feasible and effective method in the treatment of endometrial cancer.

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备注/Memo

备注/Memo:
＊通讯作者，Email:wanghailinyx@163.com
更新日期/Last Update: 2019-03-01