中国实用外科杂志

中国实用外科杂志

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机器人与腹腔镜右半结肠切除术近期疗效对照研究

刘东宁，熊凌强，邹    震，唐    城，江群广，李太原   

  1. 南昌大学第一附属医院普外五科，江西南昌 330006
  • 出版日期:2016-11-01 发布日期:2016-10-27

  • Online:2016-11-01 Published:2016-10-27

摘要：

目的    对比机器人与腹腔镜手术治疗右半结肠癌的近期疗效，评估机器人右半结肠切除术的安全性及可行性。方法    回顾性分析2014 年12 月至2016 年5月南昌大学第一附属医院普外科收治的行右半结肠切除术的60例右半结肠癌病人的临床资料，其中30例行机器人右半结肠切除术（RA组），30例行腹腔镜右半结肠切除术（LA组）。比较两组病人术中情况及术后疗效。结果    与LA组比较，RA组术中出血少［（87.3±26.1）mL vs. （132.2±31.6）mL，P<0.05］，淋巴结清扫数目多［（15.6±4.5）枚 vs. （12.5±2.9）枚，P=0.036］，手术时间长［（152.3±12.4）min vs.（125.7±29.0）min，P=0.012］，首次排气时间缩短［（61.5±9.4）h vs. （69.7±10.5）h，P=0.042］，术后疼痛轻，住院总费用高［（52235.7±528.2）元 vs. （41263.5±436.1）元，P<0.05］，差异具有统计学意义。结论    机器人右半结肠癌切除术安全可行，且与腹腔镜手术相比，其对病人损伤更小，淋巴结清扫更彻底。

关键词: 机器人手术, 结肠癌, 右半结肠切除术, 腹腔镜

Abstract:

Contrast study of short-term effect between the da Vinci surgical robot and laparoscopic technology in right hemicolectomy for colon carcinoma        LIU Dong-ning，XIONG Ling-qiang，ZOU Zhen，et al. No.5 Department of General Surgery，the First Affiliated Hospital of Nanchang University，Nanchang 330006，China
Corresponding author：LI Tai-yuan，E-mail：jylitaiyuan@sina.com
Abstract    Objective    To compare the short-term surgical outcomes of robot-assisted right hemicolectomy (RA group) with laparoscopic-assisted right hemicolectomy (LA group) for colon carcinoma in order to evaluate the safety and feasibility of robotic surgery system. Methods    The clinical data of 30 cases in RA group and 30 cases in LA group both admitted from December 2014 to May 2016 in Department of General Surgery, the First Affiliated Hospital of Nanchang University were analyzed retrospectively. Perioperative situation was compared between the two groups. Results    The estimated blood loss was significantly lower in the RA group than that in the LA group ［（87.3±26.1）mL vs. （132.2±31.6）mL，P<0.05］. The operating time in the RA group was significantly longer than that in the LA group［（152.3±12.4）min vs.（125.7±29.0）min，P=0.012］. Compared with the LA group，the times to first flatus passage were significantly shorter in the RA group［（61.5±9.4）h vs. （69.7±10.5）h，P=0.042］. The 24 hour pain scores in the RA group were significantly less than those in the LA group. Overall hospital costs in the RA group were significantly higher than that in the LA group（￥52235.7±528.2 vs. ￥41263.5±436.1，P=0.006）. Compared with the LA group，the RA group had larger number of lymph node dissection（15.6±4.5 vs. 12.5±2.9，P=0.036）. Conclusion    Compared with laparoscopic-assisted right hemicolectomy，robotic surgery has less harm to the patients，with better resection of primary tumor，and more thorough dissection of lymph nodes. Thus，it is feasible and safe for colon carcinoma.

Key words: robotic surgery, colon carcinoma, right hemicolectomy, laparoscopy