摘要
目的 对比分析腹腔镜与达芬奇机器人辅助直肠癌全直肠系膜切除术手术的临床效果.方法 回顾性分析2022年10月至2023年10月宁夏医科大学总医院结直肠外科193例直肠癌患者的临床资料,根据手术方式的不同分为腹腔镜辅助直肠癌全直肠系膜切除术组(腹腔镜组,n=136)和机器人辅助直肠癌全直肠系膜切除术组(机器人组,n=57).对比两组一般资料、临床病理学特征、手术相关指标及术后并发症相关指标.结果 两组年龄、BMI和腹部手术史比较差异有统计学意义(P＜0.05),性别和糖尿病史比较差异无统计学意义(P＞0.05).两组住院费用、ASA分级、淋巴结清扫数目比较差异有统计学意义(P＜0.05),病理类型、分化程度、肿瘤TNM分期、肿瘤大小和术前新辅助化疗情况比较差异无统计学意义(P＞0.05).两组手术时间、术中出血量、住院时间、首次通气时间、首次排粪时间和预防性造口情况比较差异有统计学意义(P＜0.05),手术方式、拔除引流管时间比较差异无统计学意义(P＞0.05).两组术后并发症相关指标比较差异无统计学意义(P＞0.05).结论 达芬奇机器人手术系统和腹腔镜应用于直肠癌全直肠系膜切除术时具有类似的肿瘤学结果,西部地区外科医师在积极开展这一技术时,需谨慎权衡其利弊,以最大程度地为患者带来福音.
Abstract
Objectives To compare and analyze the clinical effect between laparoscopic and da Vinci® robotic-assisted to-tal mesorectal excision(TME)for rectal cancer.Methods A retrospective analysis was conducted on the clinical data of 193 rectal cancer patients treated in the Department of Colorectal Surgery,General Hospital of Ningxia Medical Univer-sity,from October 2022 to October 2023.Patients were divided into two groups based on surgical approach:laparoscopic-assisted TME(laparoscopic group,n=136)and robotic-assisted TME(robotic group,n=57).General informa-tion,clinicopathological characteristics,surgical-related indicators,and postoperative complication-related indicators were compared between the two groups.Results Statistically significant differences were observed in age,BMI,and history of abdominal surgery between the two groups(P＜0.05).In contrast,no significant differences were found in gender and history of diabetes(P＞0.05).Significant differences were noted in hospitalization costs,ASA classification,and the number of lymph nodes dissected(P＜0.05).No significant differences were observed in pathological type,degree of dif-ferentiation,TNM stage of the tumor,tumor size,and preoperative neoadjuvant chemotherapy(P＞0.05).Statistically sig-nificant differences were observed in operative time,intraoperative blood loss,length of hospital stay,first flatus time,first defecation time,and the need for preventive stoma(P＜0.05).No significant differences were found in the surgical approach and drain removal time(P＞0.05).There were no significant differences in postoperative complication-related indicators between the two groups(P＞0.05).Conclusion The da Vinci® robotic surgical system and laparoscopy demon-strate similar oncologic outcomes when applied to TME for rectal cancer.Surgeons in the Western region should care-fully weigh the pros and cons of this technology when actively pursuing its implementation,aiming to maximize patient benefits.
维普
万方数据