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不同类型手术机器人全直肠系膜切除术短期疗效的比较

Comparison of short-term effects of different types of surgical robots for total mesorectal excision

  • 摘要:
    目的 以传统腹腔镜下全直肠系膜切除术(L-TME)为参照,评估不同手术机器人辅助全直肠系膜切除术(R-TME)的短期疗效。
    方法 选择2017年1月至2019年5月罹患直肠癌(临床分期cT1~3NxM0)的132例患者,其中接受达芬奇机器人手术45例、妙手S机器人手术43例和传统腹腔镜手术44例。比较3组患者术中清扫淋巴结数量、术中出血量和术后功能恢复等情况。
    结果 与腹腔镜组相比,两机器人组手术时间较长、失血量更少、淋巴结清扫数量更多、术后严重并发症发生率更低、泌尿生殖功能恢复更早(P<0.05)。两机器人组间上述指标差异均无统计学意义。
    结论 与传统腹腔镜手术相比,达芬奇及妙手S机器人TME术中清扫淋巴结数量、出血量较少,术后功能恢复更快,且两机器手术之间疗效及安全性相似。

     

    Abstract:
    Objective To evaluate the short-term efficacy of different surgical robots for total mesorectal excision (R-TME) by taking traditional laparoscopic mesorectal excision (L-TME) as a reference.
    Methods 132 patients with rectal cancer (cT1-3NxM0) were selected from January 2017 to May 2019. Among them, 45 patients received Da Vinci robot opreation, 43 patients received MicroHand S robot opreation, and 44 patients received traditional laparoscopy opreation. The number of lymph nodes dissected, intraoperative blood loss, and postoperative functional recovery were compared among the three groups.
    Results There was no difference in the efficacy between the two different types of R-TME. Compared with the L-TME group, in the two R-TME groups, the operation time was longer, blood loss was less, the number of lymph nodes dissected was more, the incidence of serious postoperative complications was lower, and the urogenital function recovery was earlier (P < 0.05).
    Conclusions Compared with L-TME, the short-term effect of Da Vinci and MicroHand S robot in total mesorectal excision show similar advantages in terms of the number of lymph nodes dissected, intraoperative blood loss, and postoperative functional recovery.

     

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