三维影像重建技术辅助机器人手术系统在宫颈癌根治术中的应用

关键词: 三维影像重建技术;机器人手术;宫颈癌根治术

张琦玲,杨蕾,张智,付振华,蔡丽萍   

  • Vol. 1 No. 2 Jun. 2020
  • DIO:10.12180/j.issn.2096-7721.2020.02.006 发布日期:2020-08-31 阅读数:572
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  • 作者简介:

探讨三维重建技术在机器人宫颈癌手术中的应用价值。方法:回顾性分析 2019 年 1 月 ~2019年 9 月南昌大学第一附属医院妇产科收治的 23 例行宫颈癌(IB1~IIA2)根治术患者的临床资料,其中三维影像重建技术辅助机器人手术系统行宫颈癌根治术 10 例(干预组),单纯机器人腹腔镜宫颈癌根治术 13 例(对照组)。对比两组手术时间、术中出血量、淋巴结切除数目、胃肠道功能恢复时间,术后拔除尿管时间、手术并发症发生率等。结果:23 例患者均顺利完成手术,无中转开腹及输血。干预组和对照组手术时间分别为(155.30±12.22)min 和(182.77±6.83)min,术中出血量分别为(67.80±9.39)ml 和(76.92±6.18)ml。术中无膀胱、输尿管及肠管损伤。术后胃肠道功能恢复时间分别为(29.50±5.56)h 和(42.31±4.70)h,术后拔除尿管时间分别为(15.60±2.12)d和(22.38±3.86)d,两组手术并发症发生率分别为 10.00% 和 30.77%。以上指标比较,差异均有统计学意义(P<0.05)。但两组的淋巴结切除数目分别为(24.60±2.50)枚和(22.62±2.26)枚,差异无统计学意义(p>0.05)。术后病理诊断均与术前相符,阴道和宫旁切缘均为阴性,均未进行放化疗,且随访研究发现恢复良好。结论:在宫颈癌根治术中,三维影像重建技术辅助机器人手术系统优势较为明显,相关并发症发生率低,且术中组织和器官损伤减轻。

To explore the application value of 3D reconstruction technology in robot-assisted radical hysterectomy. Methods: The clinical data of 23 patients underwent radical hysterectomy (IB1-IIA2) in Obstetrics and Gynecology Department of the First Affiliated Hospital of Nanchang University from January 2019 to September 2019, among which 10 cases underwent robot-assisted radical hysterectomy supported by 3D image reconstruction technology (intervention group) and 13 cases underwent robot-assisted laparoscopic radical hysterectomy (control group). The operation time, intraoperative blood loss, number of dissected lymph nodes, gastrointestinal function recovery time, catheter removing time, incidence of operative complications of the two groups were compared. Results: 23 patients were all successfully completed the operation without conversion to laparotomy or blood transfusion. The operative time of intervention group and control group were (155.30±12.22) min and (182.77±6.83)min respectively with an intraoperative bleeding volume of (67.80±9.39)ml and (76.92±6.18)ml. No injury of bladder, ureter and intestine were found.The gastrointestinal function recovery time of intervention group and control group were (29.50±5.56)h and (42.31±4.70)h respectively, and the catheter removing time were (15.60±2.12)d and (22.38±3.86)d.The incidence of operative complications in intervention group and control group were 10.00% and 30.77% respectively.All the above indexes were statistically significant (P<0.05).however, the="" number="" of="" dissected="" lymph="" nodes="" in="" intervention="" group="" and="" control="" were="" which="" has="" no="" significant="" difference="" p="">0.05).The postoperative pathological diagnosis was consistent with preoperative diagnosis.The vaginal and parametrial margins were all negative and no radiotherapy or chemotherapy was performed.The patients were well recovered in followup study. Conclusion: Robotic surgery system assisted by 3D image reconstruction technology brings advantages in radical hysterectomy, such as less surgical complications, less tissue and organ damages and shortened recovery time etc., which is more safe and feasible in radical hysterectomy