机器人辅助手术治疗成人型胆总管囊肿的疗效分析

发布时间：2018-05-15 22:27

本文选题：胆总管囊肿 + Roux-en-Y胆肠吻合术　；参考：《上海交通大学》2015年硕士论文

【摘要】：目的:评价机器人辅助手术治疗成人型胆总管囊肿的有效性、安全性及临床疗效,探讨成人型胆总管囊肿机器人辅助手术治疗的适应症及可能优势,总结手术流程和操作技巧。方法:回顾分析2010~2014年间我院应用da Vinci机器人手术系统为4例成人型胆总管囊肿患者行“胆总管囊肿切除+Roux-en-Y胆肠吻合术”手术治疗的临床资料,并与同期收治的12例成人型胆总管囊肿患者行开腹“胆总管囊肿切除+Roux-en-Y胆肠吻合术”手术治疗资料进行对比分析。通过分别记录和对比各组临床手术资料,初步评价机器人辅助手术系统在成人型胆总管囊肿治疗方法上的可能的优势,总结手术适应证、手术操作过程和技巧。结果:两组患者手术均获成功,机器人辅助手术组无一例中转开腹。机器人手术组手术时间90~170min,平均(127.5±35.0)min;术中出血量0~50ml,平均(25.0±28.9)ml,术中、术后均无输血;术后住院天数8~16d,平均(11.8±3.9)d。开腹手术组手术时间150~250min,平均(195±33.9)min;术中出血量0~300ml,平均(179.2±91.6)ml,术中、术后均无输血;术后住院天数9~24d,平均(13.8±4.4)d。机器人手术组手术时间及术中出血量均优于开腹组(P0.05)。两组患者随访5~31个月,均无复发及其他并发症出现。结论:对于成人型胆总管囊肿患者,应用机器人系统辅助行“胆总管囊肿切除+Roux-en-Y胆肠吻合术”安全、可行,手术创伤小,术后恢复快,为胆总管囊肿患者的手术治疗提供了更多选择。其优势有待进一步增加病例数及远期随访结果证实。
[Abstract]:Objective: to evaluate the efficacy, safety and clinical efficacy of robot-assisted surgery in the treatment of adult choledochal cysts, to explore the indications and possible advantages of robot-assisted surgery for adult choledochal cysts, and to summarize the surgical procedures and techniques. Methods: the clinical data of 4 adult patients with choledochal cyst underwent choledochal cyst resection Roux-en-Y choledochojejunostomy with da Vinci robotic surgical system in our hospital from 2010 to 2014 were retrospectively analyzed. The operative data of 12 adult patients with choledochal cyst treated by open choledochal cyst resection Roux-en-Y choledochojejunostomy were compared and analyzed. By recording and comparing the clinical data of each group, the possible advantages of robot-assisted surgery system in the treatment of adult choledochal cyst were evaluated, and the indications, procedures and techniques of operation were summarized. Results: the operation was successful in both groups. In the robotic operation group, the operation time was 90 ~ 170 min (mean 127.5 卤35.0 min), the blood loss was 0.50 ml (mean 25.0 卤28.9 ml), no blood transfusion was found during the operation, and the hospital stay was 816 days, with an average of 11.8 卤3.9 days. In the open operation group, the operation time was 150 ~ 250 min, the average time was 195 卤33.9 min, the blood loss was 0.300 ml, the average was 179.2 卤91.6 ml, there was no blood transfusion during the operation, and the hospital stay was 924 days, with an average of 13.8 卤4.4 days. The time of operation and the amount of intraoperative bleeding in the robot operation group were better than that in the open operation group (P 0.05). The patients in both groups were followed up for 5 ~ 31 months. No recurrence or other complications occurred. Conclusion: for adult patients with choledochal cyst, "choledochal cyst resection by Roux-en-Y choledochojejunostomy" is safe, feasible, minimal trauma and quick recovery. It provides more options for surgical treatment of choledochal cyst patients. Its advantages need to be further increased in the number of cases and long-term follow-up results confirmed.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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