机器人辅助宫颈癌根治术术后并发症影响因素分析

关键词: 达芬奇机器人;机器人辅助手术;宫颈癌根治术;并发症

黄晓天,纪妹,赵曌,何南南,李悦,许鹏琳,李喆   

  • Vol. 1 No. 2 Jun. 2020
  • DIO:10.12180/j.issn.2096-7721.2020.02.002 发布日期:2020-08-31 阅读数:732
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  • 作者简介:

探讨达芬奇机器人辅助宫颈癌根治术术后并发症的发生情况及影响因素。方法:回顾性分析郑州大学第一附属医院 2014 年 10 月 ~2019 年 6 月完成的达芬奇机器人辅助宫颈癌根治术的临床资料,统计术后并发症发生情况。各组间并发症发生率的比较采用四格表χ 2 检验,单因素比较中有差异的因素纳入多因素 Logistic 回归分析。结果:完成达芬奇机器人宫颈癌根治术 405 例,发生术后并发症 63 例(15.6%),其中下肢静脉血栓 32例(7.9%)、淋巴潴留囊肿 9 例(2.2%)、肾积水 8 例(2.0%)、生殖道瘘 6 例(1.5%)、肠梗阻 4 例(1.0%)、盆腔脓肿 4 例(1.0%)。单因素分析显示,患者的年龄、BMI、既往盆腔或腹腔手术史及合并疾病(高血压、冠心病、糖尿病)对并发症的发生率有显著影响(P<0.05)。多因素 Logistic 回归分析结果显示,患者年龄≥ 40 岁、BMI ≥ 25kg/m2、既往有盆腔或腹腔手术史及合并疾病(高血压、冠心病、糖尿病)是影响术后并发症发生的独立影响因素(P<0.05)。术后并发症以近期并发症更为常见。结论:宫颈癌根治术术后并发症以近期并发症为主,年龄≥ 40 岁、BMI ≥ 25kg/m2、有既往盆腔或腹腔手术史及合并疾病(高血压、冠心病、糖尿病)是宫颈癌根治术术后并发症发生的影响因素。

To study the incidence and influence factors to complications happens after Da Vinci roboticassisted radical hysterectomy (RARH) in treating cervical cancer. Methods: The clinical data and occurrence of postoperative complications to RARH completed by our group in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed with SPSS 21.0. Results: From October 2014 to June 2019, 405 cases of RARH were performed to treat cervical cancer by our group. No conversion to open surgery. 63 cases (15.6%) of postoperative complications were found, including 32 cases (7.9%) of lower limb venous thrombosis, 9 cases (2.2%) of Lymphocyst, 8 cases (2.0%) of hydronephrosis, 6 cases (0.6%) of genital fistula, 4 cases (1.0%) of pelvic abscess and 4 cases (1.0%) of ileus. Univariate analysis shows that patients’ age, BMI, previous pelvic or abdominal surgery history and comorbidities (hypertension, coronary heart disease, diabetes mellitus) significantly influence the incidence of complications (P<0.05). Multivariate logistic regression analysis shows that patients’ age ≥ 40 years, BMI ≥ 25kg/m2, previous pelvic or abdominal surgery and comorbidities (hypertension, coronary heart disease, diabetes mellitus) were independent influencing factors to postoperative complications (P<0.05). Conclusion: Postoperative complications are more common within 1 month after the surgery. Patients’ age ≥ 40 years, BMI ≥ 25 kg/m2, previous pelvic or abdominal surgery and comorbidities (hypertension, coronary heart disease, diabetes mellitus) are influencing factors to complications happens after radical hysterectomy in treating cervical cancer.