达芬奇机器人手术系统在宫颈癌广泛子宫切除手术中学习曲线的研究

发布时间：2018-12-30 19:28

【摘要】：目的:评估达芬奇机器人手术系统在实施宫颈癌广泛子宫切除手术的不同阶段的手术效果,探讨腹腔镜妇科医师缩短达芬奇机器人手术系统学习曲线的要点。方法:分析2010年3月至2014年4月由同组医师完成的50例达芬奇机器人手术系统在宫颈癌广泛子宫切除手术患者的临床资料。按手术先后次序分A组(15例)、B组(15例)、C组(20例),比较各组的手术效果。结果:3组间实施保留盆腔自主神经、行腹主动脉旁淋巴结切除术例数及手术时间的比较,差异均有统计学意义(P0.05),其中B组和C组明显优于A组,差异均有统计学意义(P0.05);3组术后恢复自主排尿时间比较,差异有统计学意义(P0.05),其中C组术后排尿时间最短,与A组比较,差异有统计学意义(P0.05)。3组术中出血量、术后住院时间、盆腔淋巴结切除数、围手术期并发症发生率及手术频度的比较,差异均无统计学意义(P0.05)。结论:有丰富腹腔镜宫颈癌手术经验的手术团队,经过30例的学习曲线,可掌握达芬奇机器人手术系统用于宫颈癌广泛子宫切除手术。
[Abstract]:Objective: to evaluate the effect of da Vinci robotic surgery system in different stages of extensive hysterectomy for cervical cancer, and to explore the key points for laparoscopic gynecologists to shorten the learning curve of da Vinci robot surgery system. Methods: the clinical data of 50 patients with cervical cancer undergoing extensive hysterectomy were analyzed from March 2010 to April 2014. According to the order of operation, group A (15 cases of), B group (15 cases of), C group), 20 cases of group A) were divided into two groups. Results: there were significant differences among the three groups in the number of cases of pelvic autonomic nerve preservation, the number of patients undergoing para-aortic lymphadenectomy and the time of operation (P0.05), among which group B and group C were significantly better than group A. The difference was statistically significant (P0.05). The time of spontaneous urination in group C was the shortest compared with that in group A (P0.05). The amount of intraoperative bleeding and postoperative hospitalization time in group C were significantly higher than those in group A (P0.05). There was no significant difference in the number of pelvic lymph node resection, the incidence of perioperative complications and the frequency of operation (P0.05). Conclusion: the surgical team with rich experience in laparoscopic cervical cancer surgery can master the da Vinci robotic surgical system for the extensive hysterectomy of cervical cancer after 30 cases of learning curve.
【作者单位】：第三军医大学第一附属医院;
【分类号】：R737.33

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