机器人与腹腔镜手术治疗子宫内膜癌的对比研究

A comparative study of robotic-assisted surgery versus laparoscopic surgery for endometrial cancer

摘要:

目的 对比达芬奇机器人与腹腔镜手术治疗子宫内膜癌的临床疗效，探讨达芬奇机器人手术的 有效性、安全性及学习曲线。方法 选取2016 年8 月—2018 年2 月广西医科大学第一附属医院收治的子 宫内膜癌患者，随机分为实验组和对照组。收集患者的基本信息、围手术期指标及手术费用，对数据进行统 计学分析。结果 两组患者组织学分级比较，差异有统计学意义（P <0.05）。两组患者手术时间、术中出血 量、术后排气时间、拔引流管时间、住院时间、手术费用及疼痛评分比较，差异有统计学意义（P <0.05）。 结论 达芬奇机器人辅助子宫内膜癌分期手术是一种安全有效的手术方式，比腹腔镜手术具有更好的短期手 术效果，但手术费用较高。

Abstract:

Objective To compare the clinical efficacy of Da Vinci robotic and laparoscopic surgery in the treatment of endometrial carcinoma, and to evaluate the effectiveness, safety and learning curve of robotic surgery. Methods We used a prospective randomized controlled study to randomly divide patients with endometrial cancer admitted to the First Affiliated Hospital of Guangxi Medical University from August 2016 to February 2018 into the Da Vinci robot operation group (38 cases) and the laparoscopic operation group (45 cases). The basic information, data of operation index and operation cost of all patients were collected. Then the data were analyzed. Results Comparing to laparoscopic group, the robotic group demonstrated significant advantages with respect to operative time (206.6±45.99 min vs.244.9±50.02 min, P < 0.05);blood loss (96.3±86.19 ml vs.147.6±114.12 ml, P < 0.05); anal exhaust time (1.9±0.34 d vs.2.3±0.46 d, P < 0.05); length of postoperative stay (7.3±2.54 d vs. 8.5±2.79 d, P < 0.05); postoperative pain (Z = -2.143, P < 0.05); For time of drainage tube removal, robotic group was longer than laparoscopic group (5.1±2.16 d vs.4.2±1.5 d, P < 0.05). For surgery cost, robotic group was obviously higher than laparoscopic groups (28 563±6 470 y vs.11 863±2 593 y, P < 0.05). Conclusions DaVinci Robotic surgery offers an effective and safe alternative in the surgical treatment of endometrial cancer, and has better results than laparoscopic surgery of endometrial cancer. But the cost of robot surgery is relatively high.