目的:探究第四代达芬奇机器人辅助腹腔镜与传统宫颈癌根治术的临床初期效果。方法:选取 2022 年 2 月—2024 年 2 月于西北妇女儿童医院行宫颈癌根治术的 100 例患者病例资料实施回顾性研究,按照治疗方式的不 同分为传统组(n=56,行传统腹腔镜宫颈癌根治术)和机器人组(n=44,行第四代达芬奇机器人辅助腹腔镜宫颈癌 根治术)。比较两组患者手术指标、术后恢复效果、应激指标、并发症的差异。结果:两组患者尿管重置率比较, 差异无统计学意义(P>0.05);与传统组相比,机器人组患者术中出血量、手术时间、术后补液量均更低,淋巴清 扫个数更多,首次肛门排气时间、首次排便时间、留置尿管时间、术后住院时间均更低,并发症总发生率更低,差 异有统计学意义(P<0.05)。与术前相比,术后 3 d 两组患者 CRP、IL-8、TNF-α 均升高,差异有统计学意义(P<0.05); 但机器人组患者术后 3 d CRP、IL-8、TNF-α 升高水平小于传统组,差异有统计学意义(P<0.05)。结论:相较于 传统腹腔镜宫颈癌根治术,机器人辅助腹腔镜宫颈癌根治术临床效果应用更好,可有效促进术后恢复,缓解应激反应, 减少并发症发生率。
Objective: To compare the initial clinical effect of Da Vinci robot-assisted and conventional laparoscopic radical surgery for cervical cancer. Methods: Clinical data of 100 patients who underwent radical surgery for cervical cancer in Northwest Women and Children’s Hospital from February 2022 to February 2024 were retrospectively analyzed. According to different surgical methods, they were divided into the conventional laparoscopic radical surgery group (Conventional group, n=56) and the Da Vinci robot-assisted laparoscopic radical surgery group (Robotic group, n=44). Surgical indicators, postoperative recovery conditions, stress indexes and complications were compared between the two groups. Results: There was no statistically significant difference in the replacement rate of urinary catheters between the two groups (P>0.05). Compared with the conventional group, the robotic group had lower intraoperative bleeding, shorter operative time, less fluid infusion volume after surgery, and more dissected lymph nodes (P<0.05). Compared with the conventional group, the robotic group had less time to first anal exhaust and defecation, lower catheter indwelling time, and shorter length of hospital stay after surgery (P<0.05). Compared with that before surgery, CRP, IL-8 and TNF-ɑ levels were raised in the two groups (P<0.05). However, levels of CRP, IL-8 and TNF-ɑ 3 d after surgery were higher in the robotic group than those in the conventional group (P<0.05).Compared with the conventional group, the robotic group had a lower overall incidence rate of complications (P<0.05). Conclusion: Compared to the conventional laparoscopic radical surgery, robot-assisted laparoscopic radical surgery has better clinical efficacy in the treatment of cervical cancer, which can effectively promote postoperative recovery, alleviate stress reactions, and reduce the incidence of complications.
收稿日期:2024-05-22 录用日期:2024-08-05
Received Date: 2024-05-22 Accepted Date: 2024-08-05
基金项目:西北妇女儿童医院院内科研项目(2020ZD03)
Foundation Item: Scientific Research Project of Northwest Women and Children’s Hospital(2020ZD03)
通讯作者:于帆,Email:yu182173671@163.com
Corresponding Author: YU Fan, Email: yu182173671@163.com
引用格式:郭晓云,于帆 . 机器人辅助与传统腹腔镜下宫颈癌根治术的初期临床效果对比 [J]. 机器人外科学杂志(中英文), 2024,5(6):1060-1064.
Citation: GUO X Y, YU F. Comparison of initial clinical efficacy of robot-assisted and conventional laparoscopic radical surgery for cervical cancer [J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1060-1064.
[1] 宋广东 , 王中玉 , 夏玉中 , 等 .Trendelenburg 体位达芬奇机器人 辅助腹腔镜宫颈癌根治术中应用不同剂量艾司氯胺酮对颅内压 的影响 [J]. 中华实用诊断与治疗杂志 , 2022, 36(5): 509-512.
[2] 马莉 , 纪元元 , 白睿敏 , 等 . 达芬奇机器人辅助腹腔镜宫颈癌根 治术对宫颈癌患者术后恢复效果及机体应激反应的影响 [J]. 实 用癌症杂志 , 2022, 37(11): 1855-1858.
[3] 邢文菲 , 王鑫 , 王蕊 , 等 . 达芬奇机器人辅助腹腔镜前列腺癌 根治术中患者体位优化的应用 [J]. 医学研究杂志 , 2023, 52(8): 178-180.
[4] 张安 , 王文安 , 王婧 , 等 . 达芬奇机器人与腹腔镜胃癌根治术围 手术期疗效与营养状况的对比分析 [J]. 腹腔镜外科杂志 , 2021, 26(3): 191-195.
[5] 周丹 , 王庆利 , 秦明哲 , 等 . 乌司他丁预应用对达芬奇机器人前 列腺癌根治术老年患者术后炎症因子及认知功能的影响 [J]. 中 国医药 , 2022, 17(3): 429-433.
[6] 赵施旖 , 纪妹 , 赵曌 , 等 . 达芬奇机器人辅助腹腔镜与传统腹腔 镜在超重及肥胖的高龄子宫内膜癌患者中的疗效对比分析 [J]. 实用妇产科杂志 , 2023, 39(3): 200-204.
[7] 何清远 , 于建平 , 李洪涛 , 等 . 达芬奇机器人手术系统辅助与腹 腔镜辅助近端胃癌根治性全胃切除 + 保脾脾门淋巴结清扫的短 期疗效研究 [J]. 中国现代医学杂志 , 2022, 32(19): 7-12.
[8] LI B B, LU S L, HE X, et al. Da Vinci robot-assisted pancreatoduodenectomy in a patient with situs inversus totalis: A case report and review of literature[J]. World J Gastrointest Oncol, 2022 , 14(7): 1363-1371.
[9] 刘清泉 , 肖大雷 .达芬奇机器人辅助直肠癌根治术的效果观察 [J]. 实用临床医药杂志 , 2022, 26(13): 50-54.
[10] 叶勇 , 张秋杰 , 胡康 , 等 . 达芬奇机器人手术系统辅助和腹腔镜 辅助全结肠系膜切除术治疗右半结肠癌的疗效分析 [J]. 中华消 化外科杂志 , 2021, 20(5): 535-542.
[11] 周潇妮 , 唐旭秀 , 蔡丽萍 , 等 . 新辅助化疗后机器人辅助与开腹 手术治疗局部晚期子宫颈癌术后生存影响因素的对比分析 [J]. 机器人外科学杂志 ( 中英文 ), 2024, 5(2): 178-185.
[12] 孟元光, 王楠.达芬奇机器人在妇科恶性肿瘤MDT手术的应用[J]. 中华腔镜外科杂志电子版 , 2023, 16(5): 257-261.
[13] 高庚妹 , 江群广 , 唐博 , 等 . 达芬奇机器人手术系统和腹腔镜胃 癌根治术后淋巴结检出数目的影响因素分析 ( 附 1396 例报告 )[J]. 中华消化外科杂志 , 2021, 20(5): 512-518.
[14] 李琳 , 赵倩 , 郝璐瑶 , 等 . 机器人辅助腹腔镜下子宫颈癌术后 盆腔淋巴囊肿形成的危险因素分析 [J]. 中国妇产科临床杂志 , 2022, 23(2): 124-126.
[15] 王亚菲 , 杨英捷 , 孙清华 , 等 . 达芬奇机器人手术系统在妇科肿 瘤治疗中的应用 [J]. 医学综述 , 2023, 29(4): 686-691.
[16] Loniewski S, Farah K, Malikov S, et al. Da Vinci robotic-assisted anterolateral lumbar arthrodesis: operative technique[J]. Acta Neurochir (Wien), 2023, 165(9): 2711-2716.
[17] 陆艳 , 何奕卉 , 周东升 , 等 . 达芬奇机器人与腔镜甲状腺癌根治 术的对比研究 [J]. 腹腔镜外科杂志 , 2023, 28(3): 171-175.