中国的机器人外科学杂志 | ISSN 2096-7721 | CN 10-1650/R

机器人辅助腹腔镜胃间质瘤切除术的临床疗效分析

Clinical effect of robot-assisted laparoscopic resection for gastric stromal tumor

作者:白桦,肖大雷,白文学,李世楠,唐海龙,何祥午

Vol. 5 No. 4 Aug. 2024 DOI: 10.12180/j.issn.2096-7721.2024.04.029 发布日期:2024-10-23
关键词:机器人辅助手术;腹腔镜手术;胃间质瘤

作者简介:

目的:分析机器人辅助腹腔镜胃间质瘤切除术的临床疗效。方法:回顾性分析齐齐哈尔市中医医院 和漯河市中心医院 2019 年 1 月—2022 年 6 月收治的 125 例行胃间质瘤切除术的患者临床资料。按手术方法分为两 组,即机器人组(n=48)和腹腔镜组(n=77),机器人组行机器人辅助腹腔镜胃间质瘤切除术,腹腔镜组行腹腔镜 下胃间质瘤切除术。对比两组患者手术效果、并发症及免疫炎症反应等。结果:机器人组手术时间、初次进食时间、 胃肠减压管及腹腔引流管拔除时间短于腹腔镜组,差异有统计学意义(P<0.05),而比较两组患者术中出血量、消 化道重建时间及住院时间,差异无统计学意义(P>0.05)。机器人组术中出现中转开腹率和肿瘤破裂率低于腹腔镜 组,但差异无统计学意义(P>0.05)。比较机器人组与腹腔镜组术后并发症发生率及并发症严重分级,差异无统计 学意义(P>0.05)。机器人组术后免疫功能高于腹腔镜组,炎症反应低于腹腔镜组,差异有统计学意义(P<0.05)。 结论:与腹腔镜手术相比,机器人辅助腹腔镜胃间质瘤切除术能够缩短手术操作时间,减少并发症,减轻手术对患 者免疫功能的影响,临床值得应用。

Objective: To analyze the clinical effect of robot-assisted laparoscopic resection for gastric stromal tumor. Methods: The clinical data of 125 patients who underwent gastric stromal tumor resection in Qiqihar Hospital of Traditional Chinese Medicine and Luohe Central Hospital from January 2019 to June 2022 were retrospectively analyzed. They were divided into the robotic group (n=48) and the laparoscopic group (n=77) according to the surgical method.The operative effect, complications and immune indexes were compared between the two groups of patients. Results: The operative time, first feeding time, gastrointestinal decompression tube and abdominal drainage tube removal time of the robotic group were shorter than those of the laparoscopic group, and the differences were statistically significant (P<0.05), while the differences in intraoperative blood loss, digestive tract reconstruction time and hospital stay between the two groups were not statistically significant (P>0.05). The rates of conversion to laparotomy and tumor rupture in the robotic group were lower than those in the laparoscopic group, and the differences were not statistically significant (P>0.05). There was no significant difference in the incidence and severity of postoperative complications between the two groups (P>0.05). The immune function of the robotic group was higher than that of the laparoscopic group, and the inflammatory response indicators were lower than that of the laparoscopic group, the differences were statistically significant (P<0.05). Conclusion: Compared with laparoscopic surgery, robot-assisted laparoscopic gastric stromal tumor resection could shorten the operative time, reduce complications, and lower the impact of surgery on patients’ immune function, which is worthy of clinical application.

稿件信息

收稿日期:2024-01-04  录用日期:2024-03-16

Received Date: 2024-01-04  Accepted Date: 2024-03-16 

基金项目:齐齐哈尔市科技计划创新激励项目(CSFGG-2021182) 

Foundation Item: Innovation Incentive Project of Science and Technology Plan of Qiqihar City (CSFGG-2021182) 

通讯作者:何祥午,Email:734337765@qq.com 

Corresponding Author: HE Xiangwu, Email: 734337765@qq.com 

引用格式:白桦,肖大雷,白文学,等 . 机器人辅助腹腔镜胃间质瘤切除术的临床疗效分析 [J]. 机器人外科学杂志(中英文), 2024,5(4):654-658. 

Citation: BAI H, XIAO D L, BAI W X, et al. Clinical effect of robot-assisted laparossoopic resection for gastric stromal tumor[J]. Chinese Journal of Robotic Surgery, 2024, 5(4): 654-658.

参考文献

[1] Klug L R, Khosroyani H M, Kent J D, et al. New treatment strategies for advanced-stage gastrointestinal stromal tumours[J]. Nat Rev Clin Oncol, 2022 , 19(5): 328-341. 

[2] Chavan R, Shah A, Mevada S, et al. Gastrointestinal: endoscopic ultrasound of rectal subepithelial lesion mimicking gastrointestinal stromal tumor[J]. J Gastroenterol Hepatol, 2022, 37(11): 2028. 

[3] Otsuka S, Horii J, Hamano R, et al. [Laparoscopic Surgery for Gastric Gastrointestinal Stromal Tumors][J]. Gan To Kagaku Ryoho, 2022 , 49(13): 1720-1722. 

[4] 赵敏 , 谭韡 , 罗和生 . 胃困难部位间质瘤内镜与腹腔镜治疗 临床疗效比较 [J]. 胃肠病学和肝病学杂志 , 2023, 32(5): 499- 504, 513. 

[5] 何裕隆 . 胃肠间质瘤外科诊治共识和争议 [J]. 中华胃肠外科杂 志 , 2013, 16(3): 201-203. 

[6] 李泽伦 . 机器人手术系统在胃肠间质瘤中的应用进展 [J]. 中国 微创外科杂志 , 2023, 23(5): 394-397. 

[7] 中国临床肿瘤学会胃肠间质瘤专家委员会 , 中国抗癌协会胃肠 间质瘤专业委员会 , 中国医师协会外科医师分会胃肠道间质瘤 诊疗专业委员会. 小胃肠间质瘤诊疗中国专家共识(2020年版)[J]. 临床肿瘤学杂志 , 2020, 25(4): 349-355. 

[8] 张树庚 , 张少博 , 朱泽斌 , 等 . Clavien-Dindo 分级系统分析不同 供肝类型肝移植患者术后早期并发症发生率比较研究 [J]. 实用 肝脏病杂志 , 2023, 26(5): 738-741. 

[9] Chiguchi G, Cho H, Sato S, et al. Impact of preoperative tumor rupture timing on gastrointestinal stromal tumor prognosis: a retrospective multicentric cohort study[J]. Jpn J Clin Oncol, 2022, 52(3): 237-243. 

[10] Mishima K, Matsutani T, Yamagiwa R, et al. Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report[J]. Surg Case Rep, 2022, 8(1): 109. 

[11] Hanayama H, Katagata M, Sato T, et al. Clinical outcomes of laparoscopic and endoscopic cooperative surgery for gastric gastrointestinal stromal tumor[J]. Fukushima J Med Sci, 2022, 68(3): 169-174. 

[12] 张维富 , 冯兴宇 , 张鹏 , 等 . 不同腹腔镜手术治疗胃底贲门部 胃肠间质瘤疗效的多中心研究 [J]. 中华消化外科杂志 , 2023, 22(4): 519-525. 

[13] 刘捷 , 王钧 . 机器人辅助腹腔镜联合胃镜切除胃间质瘤的手术 配合体会 [J]. 机器人外科学杂志 ( 中英文 ), 2023, 4(6): 561-566. 

[14] 王立文 , 柳欣欣 , 刘江 , 等 . 机器人全腹腔内低位直肠癌 APR 联合胃间质瘤切除术一例报道 [J]. 腹部外科 , 2022, 35(6): 462-464. 

[15] 徐子鹏 , 汪文杰 , 余稳稳 , 等 . 达芬奇机器人手术系统辅助与腹 腔镜辅助胃肠间质瘤手术的近期疗效分析 [J]. 中华消化外科杂 志 , 2018, 17(9): 914-918. 

[16] 谢京茂 , 雷阳 , 张皓 , 等 . 机器人辅助与腹腔镜辅助胃切除 术学习曲线的比较 [J]. 中南大学学报 ( 医学版 ), 2023, 48(5): 716-724. 

[17] Torres M B, Dixon M B, Gusani N J, et al. Robotic excision of a duodenal gastrointestinal stromal tumor[J]. Ann Surg Oncol, 2021, 28(13): 8977-8978. 

[18] Sakai A, Kinoshita J, Yamaguchi T, et al. Robot-assisted distal gastrectomy for duodenal gastrointestinal stromal tumors adhering to the pancreas: a case report[J]. J Surg Case Rep, 2023 , 2023(2): rjad024. 

[19] Krzystek-Korpacka M, Zawadzki M, Szufnarowski K, et al. The perioperative dynamics of IL-7 following robot-assisted and open colorectal surgery[J]. Sci Rep, 2018, 8(1): 9126. 

[20] Marano A, Allisiardi F, Perino E, et al. Robotic treatment for large duodenal gastrointestinal stromal tumor[J]. Ann Surg Oncol, 2020 , 27(4): 1101-1102. 

[21] Hirata Y, Scally C, Badgwell B D, et al. Robotic excision of gastric and duodenal gastrointestinal stromal tumor[J]. Updates Surg, 2022, 74(4): 1483-1484. 

[22] 周明梁 , 宋章法 , 李振军 . 腹部无辅助切口的达芬奇机器人手 术切除直肠间质瘤 1 例 [J]. 中国癌症杂志 , 2022, 32(1): 75-79. 

印象笔记
有道云笔记
微博
QQ空间
微信
二维码
意见反馈