达芬奇机器人与腹腔镜结肠癌根治术围术期指标比较

Short-term outcome of Da Vinci robotic versus laparoscopic radical colectomy for colon cancer

  • 摘要: 目的 比较达芬奇机器人与腹腔镜结肠癌根治术的临床疗效。 方法 回顾性分析2013年8月-2017年8月本院普通外科实施结肠癌根治手术的277例患者临床资料,其中行达芬奇机器人结肠癌根治术130例(机器人组),腹腔镜结肠癌根治术147例(腹腔镜组),比较两组围术期相关指标。 结果 与腹腔镜组相比,机器人组术中出血更少(84.66±17.38) ml vs (97.38±26.19) ml,P=0.000,住院时间更短(7.13±2.09) d vs (8.32±1.49) d,P=0.000,住院费用更昂贵(9.63±1.61)万元vs (6.30±1.77)万元,P=0.000;两组淋巴结清扫数、术后排气时间、术后进食时间、引流管及尿管留置时间、术后并发症发生率等差异均无统计学意义(P均> 0.05)。 结论 达芬奇机器人结肠癌根治术具有与腹腔镜手术相同的安全性和有效性,且出血更少,但费用较高。

     

    Abstract: Objective To compare the short-term clinical outcomes of Da Vinci robotic versus laparoscopic radical colectomy for colon cancer. Methods Clinical data about 277 patients who underwent Da Vinci robotic radical colectomy (n=130) or laparoscopic radical colectomy (n=147) in department of general surgery, Chinese PLA General Hospital from August 2013 to August 2017 were analyzed retrospectively. Perioperative variables were compared between the two groups. Results Compared with laparoscopic group, patients in robotic group had significantly less blood loss(84.66±17.38) ml vs (97.38±26.19) ml, P=0.000, shorter hospital stay(7.13±2.09) d vs (8.32±1.49) d, P=0.000, higher hospitalization costs(96.3±16.1) thousand yuan vs (63.0±17.7) thousand yuan, P=0.000. There was no significant difference in number of lymph nodes retrieved, intestinal function recovery time, time to liquid food intake, time to remove the urinary catheter and abdominal catheter and postoperative complications. Conclusion Robotic colectomies offer comparable safety and effectiveness as laparoscopic approaches for colon cancer, while it has less blood loss and higher costs.

     

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