目的:探讨机器人辅助腹腔镜下改良宫颈癌根治术在宫颈癌治疗中的优势与不足。方法:选取 2021 年 4 月—2023 年 10 月行机器人辅助腹腔镜下改良宫颈癌根治术的 100 例 IA2~IB2、ⅡA1 期宫颈癌患者作为研究组,选取 2019 年 9 月—2021 年 3 月行普通腹腔镜下改良宫颈癌根治术的 120 例 IA2~IB2、ⅡA1 期宫颈癌患者作为对照组,统计 分析两组患者的一般资料、术中临床资料、术后临床资料、术后病理资料及术后近期并发症发生情况。结果:两组 患者均顺利完成手术,术中均无中转开腹及重大周围脏器损伤。两组患者一般资料比较,差异无统计学意义(P>0.05)。 两组患者术中临床资料中,与对照组相比,研究组手术时间更短,术中出血量更少,血管损伤率更低(P<0.05)。 两组患者术后临床资料中,与对照组相比,研究组住院天数、通气时间、尿管拔除时间更短,术后 12 h 内视觉模拟 评分法(Visual Analogue Scale,VAS)评分、抗生素升级率更低(P<0.05)。两组患者术后病理资料中,与对照组 相比,研究组清扫淋巴结数目更多(P<0.05)。两组患者术后近期并发症发生率比较,差异无统计学差异(P>0.05)。 结论:机器人辅助腹腔镜下改良宫颈癌根治术在宫颈癌手术治疗中具有手术时间短、术中出血量少、术后恢复快等 特点,更符合根治性宫颈癌切除术的微创理念。
Objective: To investigate the advantages and shortcomings of robot-assisted laparoscopic modified radical hysterectomy for cervical cancer in the treatment of cervical cancer. Methods: 100 cases of IA2-IB2 and IIA1 stage cervical cancer patients who underwent robot-assisted laparoscopic modified radical hysterectomy for cervical cancer from April 2021 to October 2023 were selected into the study group, and 120 cases of IA2-IB2 and IIA1 stage cervical cancer patients who underwent ordinary laparoscopic radical hysterectomy from September 2019 to March 2021 were selected into the control group. The general data, intraoperative clinical data, postoperative clinical data, postoperative pathological data and the occurrence of short-term complications of the two groups were statistically analyzed. Results: Am surgeries were successfully completed, and there was no conversion to laparotomy or major peripheral organ injury. Comparing the general data of patients in the two groups, the difference was not statistically significant (P>0.05). Compared with the control group, the study group had a shorter operative time, less intraoperative bleeding and a lower rate of vascular injury (P<0.05). Compared with the control group, the study group had shorter length of hospita stay, exhaust time, urinary catheter removal time, and a lower Visual Analogue Scale (VAS) score and antibiotic escalation rate in the postoperative period of 12 h (P<0.05). In terms of the postoperative pathologic data of the two groups of patients, the number of dissected lymph nodes was higher in the study group than that in the control group (P<0.05). There was no statistical difference in the incidence of short-term complications between the two groups of patients (P>0.05). Conclusion: Robot-assisted laparoscopic modified radical hysterectomy for cervical cancer is characterized by shorter operative time, less intraoperative bleeding, and faster postoperative recovery, which is more in line with the minimally invasive concept of radical hysterectomy.
收稿日期:2024-03-26 录用日期:2024-05-07
Received Date: 2024-03-26 Accepted Date: 2024-05-07
基金项目:宁夏回族自治区重点研发计划项目(2023BEG01001)
Foundation Item: Key R&D Plan project of Ningxia Hui Autonomous Region (2023BEG01001)
通讯作者:哈春芳,Email:hachunfang@163.com
Corresponding Author: HA Chunfang, Email: hachunfang@163.com
引用格式:李贝,陈华,张瑞琪,等 . 机器人辅助腹腔镜下改良宫颈癌根治术的疗效分析 [J]. 机器人外科学杂志(中英文),2024, 5(6):1077-1082.
Citation: LI B, CHEN H, ZHANG R Q, et al. Efficacy analysis of robot-assisted laparoscopic modified radical hysterectomy in the treatment of cervical cancer[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1077-1082.
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