机器人全腔镜-单吻合治疗直肠癌的临床疗效

发布时间：2018-06-04 18:12

本文选题：直肠肿瘤 + 机器人手术　；参考：《中国普通外科杂志》2017年04期

【摘要】：目的:探讨达芬奇机器人全腔镜-单吻合手术治疗直肠癌的安全与可行性及术后近期疗效。方法:回顾性分析2016年1月—2017年2月在重庆医科大学附属第一医院施行直肠癌手术的124例患者资料,其中有26例行达芬奇机器人手术(机器人组),另98例行传统腹腔镜手术(腹腔镜组),比较两组患者的相关临床指标。结果:两组患者的基本临床资料差异均无统计学意义(均P0.05),具有可比性。与腹腔镜组比较,机器人组手术时间较明显延长(273.5minvs.234.3min),住院总费用明显增加(8.2万元vs.7.2万元),但术中出血量(43.3mLvs.68.4mL),术后排气时间(3.3dvs.4.4d)、进流食时间(3.9dvs.5.4d)、下床时间(4.5dvs.6.8d)、拔除尿管时间(5.0dvs.6.8d)及术后住院时间(10.0dvs.12.3d)均明显缩短(均P0.05)。两组均无中转开腹;两组的远切缘距离、切除淋巴结个数、环周切缘阳性率及术后并发症发生率均无统计学差异(均P0.05)。结论:机器人全腔镜-单吻合用于直肠癌治疗是一项安全且可行的手术方式,具有创伤小、术后恢复快、住院时间短等的优点,但远期疗效需进一步随访。
[Abstract]:Objective: to evaluate the safety and feasibility of complete endoscope-single anastomosis with Leonardo da Vinci robot in the treatment of rectal cancer. Methods: the data of 124 patients undergoing rectal cancer surgery in the first affiliated Hospital of Chongqing Medical University from January 2016 to February 2017 were retrospectively analyzed. There were 26 cases of Leonardo da Vinci robot operation (robot group) and 98 cases of traditional laparoscopic surgery (laparoscopic group). Results: there was no significant difference in basic clinical data between the two groups (P 0.05). Compared with the laparoscopic group, In the robot group, the operation time was significantly prolonged 273.5 min vs.234.3 min, the total hospitalization cost was significantly increased (82000 Yuan vs.7.2, but the intraoperative bleeding volume was 43.3 mLvs.68.4 mL / L, the postoperative exhaust time was 3.3dvs.4.4 dL, the feeding time was 3.9dvs.5.4dL, the time of getting out of bed was 4.5dvs.6.8dU, the time of extubation was 5.0dvs.6.8d) and the postoperative hospitalization time was 10.0dvs.12.3 d) All of them were shortened significantly (P 0.05). The distance between the two groups, the number of lymph nodes removed, the positive rate of circumferential margin and the incidence of postoperative complications were not significantly different between the two groups (all P 0.05). Conclusion: robotic endoscopy-single anastomosis is a safe and feasible surgical method for rectal cancer. It has the advantages of less trauma, faster postoperative recovery and shorter hospital stay, but further follow-up is needed.
【作者单位】：重庆医科大学附属第一医院胃肠外科;云南省肿瘤医院/昆明医科大学第三附属医院结直肠外科/大肠癌临床研究中心;
【分类号】：R735.37

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