分析 Da Vinci 机器人手术系统与传统腹腔镜在宫颈癌根治术中淋巴结清扫范围及术后淋巴清扫相关并发症的差异，以期为临床治疗提供参考，为医患双方选择手术方式提供更为客观的依据。方法：选取 2016年 2 月 ~2018 年 2 月重庆医科大学附属第一医院收治的行宫颈癌根治术的患者 237 例，其中 LRH（Conventionallaparoscopic radical hysterectomy）组 153 例，RRH（Robot-assisted radical hysterectomy）组 84 例。在 IA2~IIA 期宫颈癌根治术中，分析比较两组患者淋巴结切除数目、淋巴结转移情况、术中并发症的发生率、术后恢复情况、术后并发症的发生率有无差异，并分析淋巴结清扫相关并发症可能影响因素及其相关性。结果：两组患者在术后保留尿管时间 [RRH：14（3）d，LRH：14（0）d；P<0.05]、术后引流量 [LRH：110（247.5）ml，RRH：191（368）ml；P<0.05] 及术中出血量 [RRH：80（50）ml，LRH：100（100）ml；P<0.05] p="">0.05）。淋巴囊肿的发生与淋巴结切除数目、术前白蛋白水平、术前血红蛋白水平、年龄、术后引流量均无显著相关（P>0.05）；淋巴结切除数目与淋巴结转移情况、会阴及双下肢水肿亦均无显著相关（P>0.05）。此外，术后引流量与分期无显著相关（P>0.05）；然而术后拔出盆腔引流管时间与术后引流量成正相关（P<0.001）。结论：Da Vinci 机器人手术系统是相对安全可行、有效的手术方式。在宫颈癌根治术中，RRH 术后淋巴结清扫相关并发症发生率较 LRH 更低，且术中出血量显著更少（P<0.05）、术后保留尿管时间显著更短（P<0.05），可以作为安全可靠的手术方式。

To analyze the differences between Da Vinci robotic surgery system and conventional laparoscopic surgery on lymph node dissection scope in radical hysterectomy and the postoperative complications related to lymphadenectomy. So that to provide a reference for clinical practice and bring both doctors and patients an objective evidence when choosing operation approaches. Methods: 237 patients with cervical cancer underwent radical hysterectomy in the First Affiliated Hospital of Chongqing Medical University from February 2016 to February 2018 were selected, including 153 cases in LRH (conventional laparoscopic radical hysterectomy) group and 84 cases in RRH (robot-assisted radical hysterectomy) group. In the stage of IA2-IIA radical hysterectomy, the number of lymph nodes obtained, lymph node metastasis, the incidence of intraoperative complications, postoperative recovery and the incidence of postoperative complications were compared between the two groups. The possible influencing factors on lymphadenectomy complications and correlations were analyzed. Results: There were significant difference between the two groups in catheter retention time[RRH: 14 (3) d, LRH: 14 (0) d, P<0.05], postoperative drainage volume[LRH: 110 (247.5) ml, RRH: 191 (368) ml, P<0.05]and intraoperative bleeding volume[RRH: 80 (50) ml, LRH: 100 (100) ml, P<0.05]. there="" was="" no="" significant="" difference="" between="" the="" two="" groups="" in="" number="" of="" lymph="" nodes="" node="" operation="" anal="" exhaust="" postoperative="" hospital="" pelvic="" drainage="" tube="" retention="" intraoperative="" and="" complications="" p="">0.05). There was no significant correlation on the number of lymph nodes obtained and preoperative albumin level, preoperative hemoglobin level, age or postoperative drainage (P>0.05), as well as the number of lymph nodes obtained and lymph node metastasis or perineum and lower extremity edema (P>0.05). Besides, there was no significant correlation between postoperative drainage and stage (P>0.05). However, there was a positive correlation on postoperative pelvic drainage tube retention time and postoperative drainage volume (P<0.001). Conclusion: In Radical hysterectomy of cervical cancer, the incidence of complications related to Lymphadenectomy in RRH group is lower than that in LRH group, but there is no significant difference in statistics. However, the intraoperative bleeding volume in RRH group is significantly less (P<0.05) than that in LRH group and the time of urinary tube retention is significantly shorter than that in LRH group (P<0.05), which indicates Da Vinci robotic surgery is a safe and reliable approach in treating cervical cancer.

收稿日期：2020-02-18  录用日期：2020-05-20

Received Date: 2020-02-18  Accepted Date: 2020-05-20

通讯作者：肖琳，Email: 1258210371@qq.com

Corresponding Author: XIAO Lin, Email: 1258210371@qq.com

引用格式：黄聂笑，肖琳，马丹，等 . 机器人辅助腹腔镜下盆腔淋巴结清扫与传统腹腔镜下盆腔淋巴结清扫的对比研究 [J]. 机器人外科学杂志，2020，1（2）：77-85.

Citation: HUANG N X, XIAO L, MA D, et al. Comparison between robot-assisted radical hysterectomy and conventionallaparoscopic radical hysterectomy [J]. Chinese Journal of Robotic Surgery, 2020, 1 (2): 77-85.

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