[1]叶善平① 时军 江群广 邱华① 刘东宁 雷雄 高庚妹① 李太原**.达芬奇机器人与腹腔镜辅助直肠癌Dixon术近期疗效的对比研究[J].中国微创外科杂志,2019,01(10):898-902.
　Ye Shanping,Shi Jun*,Jiang Qunguang*,et al.Comparative Study of Short-term Efficacy of Robotic-assisted Versus Laparoscopic-assisted Dixon’s Radical Surgery for Rectal Cancer[J].Chinese Journal of Minimally Invasive Surgery,2019,01(10):898-902.
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达芬奇机器人与腹腔镜辅助直肠癌Dixon术近期疗效的对比研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年10期
页码:
898-902
栏目:
临床研究
出版日期:
2019-10-25

文章信息/Info

Title:
Comparative Study of Short-term Efficacy of Robotic-assisted Versus Laparoscopic-assisted Dixon’s Radical Surgery for Rectal Cancer
作者:
叶善平① 时军 江群广 邱华① 刘东宁 雷雄 高庚妹① 李太原**
（南昌大学第一附属医院普通外科，南昌330006）
Author(s):
Ye Shanping;  Shi Jun*;  Jiang Qunguang*;  et al.
*Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang 330006, China
关键词:
直肠癌根治术; 达芬奇手术系统; 腹腔镜; C反应蛋白; 性功能
Keywords:
Radical resection of rectal cancer; da Vinci Surgical System; Laparoscopy; C-reactive protein; Sexual function
文献标志码:
A
摘要:
目的探讨达芬奇机器人与腹腔镜辅助直肠癌Dixon术的近期临床疗效。方法回顾性分析2016年3月～2018年5月我科达芬奇机器人（机器人组，n=53）或腹腔镜辅助（腹腔镜组，n=58）直肠癌Dixon术的临床资料，比较2组手术时间、术中出血量、术后24 h C反应蛋白、术后肛门首次排气时间、术后尿管留置时间、腹腔引流管留置时间、术后并发症、术后住院时间、淋巴结清扫数目和术后男性性功能评分等。结果机器人组手术时间（136.7±11.4）min，明显长于腹腔镜组（124.1±21.5）min（t=3.827，P=0.000）；术中出血量（69.7±12.0）ml ，明显少于腹腔镜组（75.3±13.2）ml（t=-2.370，P=0.020）；术后尿管留置时间中位数3 d（1～6 d），明显短于腹腔镜组4 d（2～6 d）（Z=-3.029，P=0.002）；术后24 h C反应蛋白（53.3±7.9）mg/L,明显低于腹腔镜组（57.1±6.3)mg/L(t=-2.829,P=0.006);术后男性性功能评分（19.0±3.1）分，明显高于腹腔镜组（17.1±3.3）分（t=2.186，P=0.033）。机器人组和腹腔镜组淋巴结清扫数目分别为（16.9±3.8）、（16.5±3.7）枚，术后肛门首次排气时间分别为（54.7±6.7）、（55.6±7.4）h，术后腹腔引流管留置时间中位数分别为6（5～24）、6（4～28）d，术后住院时间中位数分别为7（6～26）、7.5（5～30）d，术后并发症分别为9、8例，均无统计学差异（P>0.05）。结论与腹腔镜辅助直肠癌Dixon术比较，达芬奇机器人手术安全可行，且术中出血更少、炎症反应轻、盆腔自主神经损伤更轻，值得推广应用。
Abstract:
ObjectiveTo compare the short-term outcomes of robotic-assisted versus laparoscopic-assisted Dixon’s radical surgery for rectal cancer. MethodsA retrospective cohort study was performed. One hundred and eleven patients underwent robotic or laparoscopic assisted Dixon’s radical surgery for rectal cancer from March 2016 to May 2018 in our department. Fifty-three patients were operated by robot (robotic group, n=53) and fifty-eight patients were performed by laparoscopy (laparoscopic group, n=58). The operation time, intraoperative bleeding volume, 24 h C-reactive protein, first anal exhaust time, urinary catheter indwelling time, abdominal drainage tube indwelling time, complications, hospitalization time, number of lymph node dissection and male sexual function score were compared between the two groups. ResultsThe operation time of robotic group was (136.7±11.4) min, significantly longer than that of laparoscopic group ［(124.1±21.5) min, t=3.827, P=0.000］. The intraoperative bleeding volume of robotic group ［(69.7±12.0)ml］ was significantly less than that of laparoscopic group ［(75.3±13.2) ml, t=-2.370, P=0.020］. The median indwelling time of urinary catheter after operation was 3 days (range, 1-6 days), significantly shorter than that of laparoscopic group ［4 days (range, 2-6 days), Z=-3.029, P=0.002］. The 24 h C-reactive protein of robotic group was (53.3±7.9)mg/L,significantly lower than that of laparoscopic group ［(57.1±6.3) mg/L, t=-2.829,P=0.006］.The score of male sexual function of robotic group ［(19.0±3) points］ was significantly higher than that of laparoscopic group ［(17.1±3.3) points, t=2.186, P=0.033］. The number of lymph node dissections in robotic group and laparoscopic group were (16.9±3.8) and (16.5±3.7), respectively. The first time of anal exhaust after operation was (54.7±6.7) h and (55.6±7.4) h. The median time of indwelling abdominal drainage tube after operation was 6 (range, 5-24) and 6 (range, 4-28) days. The median time of hospitalization after operation was 7 (range, 6-26) and 7.5 (range, 5-30) days, and complications after operation were 9 and 8 cases, respectively, with no statistical differences (P>0.05).ConclusionCompared with laparoscopic-assisted Dixon’s radical surgery for rectal cancer, robotic surgery not only has similar safety and feasibility, but also has advantages of less volume of intraoperative blood loss, inflammation response and damage of pelvic autonomic nerve.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金(81560397)；江西省教育厅科学技术研究项目(201414040)；江西省科技厅科研院所基础设施配套项目（20142BBA13039）**通讯作者，E-mail:jylitaiyuan@sina.com ①（南昌大学江西医学院， 南昌330006）
更新日期/Last Update: 2020-01-09