Application of da Vinci robotic surgical system in pancreaticoduodenectomy
Objective To observe the clinical application of robotic pancreaticoduodenectomy(RPD).Methods Totally 308 patients with benign and malignant tumors of the pancreatic head,lower common bile duct,periampullary re-gion,or duodenum who underwent pancreaticoduodenectomy were divided into three groups according to different surgical methods.Among these three groups,there were 46 cases in the RPD group,138 cases in the open pancreatoduodenecto-my(OPD)group,and 124 cases in the laparoscopic pancreaticoduodenectomy(LPD)group.After surgery,the efficacy evaluation indicators(R0 resection rate,postoperative hospitalization days,lymph node dissection number,and lymph node positive rate)and the safety evaluation indicators(operation time,intraoperative blood loss,blood transfusion rate,conversion to laparotomy rate,complication rate,ICU admission rate,unplanned reoperation rate,readmission rate half a month after discharge,and mortality within 90 days after surgery)were recorded.We compared the efficacy and safety of the three groups.Results The median postoperative hospitalization days of patients in the RPD group,OPD group,and LPD group were 11.5,17,and 15 days.Compared with the LPD group and the OPD group,the postoperative hospi-talization time of the patients in the RPD group was shorter(both P<0.05).Compared with the OPD group,the postoper-ative hospitalization time of patients in the LPD group was shorter(P<0.05).The median operation time of patients in the RPD group,OPD group,and LPD group was 317.5,320,and 350 minutes,the median intraoperative blood loss was 300,300,and 250 mL,and the blood transfusion rates were 4.3%,26.8%,and 20.2%.Compared with the LPD group and the OPD group,the patients in the RPD group had less intraoperative bleeding and a lower blood transfusion rate(all P<0.05).There was no statistically significant difference in the occurrence of postoperative complications among the three groups.Conclusions Compared with OPD and LPD,RPD has certain advantages in reducing intraoperative bleeding,reducing blood transfusion rate,and shortening postoperative hospitalization time.The therapeutic effect is bet-ter and safer.
万方数据
维普
