机器人脾切除术与腹腔镜脾切除术的安全性和可行性比较研究

中华普通外科杂志 Pub Date : 2020-01-25 DOI:10.3760/CMA.J.ISSN.1007-631X.2020.01.009

Weikai Chen, Yanan Zhang, Jianping Yu, Wenwen Yu, Jing Wang, Hong-Bin Liu

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引用次数: 0

摘要

目的探讨机器人脾切除术的安全性和可行性。方法对2015年1月至2019年9月在解放军联勤保障部队940医院行机器人或腹腔镜脾切除术的65例患者进行回顾性分析。结果机器人脾切除术组和腹腔镜脾切除术组的手术时间和住院总费用分别为(167±34)min和(123±24)min, t=8.554, P=0.00;(73 002±21 009)元和(42 095±9 999)元，t=6.484, P=0.00。腹腔镜组转为开腹手术3例。在脾门厚度≥5 cm亚组中，机器人组术中出血量(145±67)ml vs.腹腔镜组(263±180)ml，差异有统计学意义(t=-2.195, P=0.04)。VAS评分(3±1)比(4±1)，差异有统计学意义(t=2.175, P=0.04)。结论机器人脾切除术安全可行。对于脾肿大患者，机器人手术比腹腔镜手术更具微创优势，但成本高，耗时长。关键词:脾切除术;机器人技术;镜头辅助

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Comparative study on safety and feasibility between robot splenectomy and laparoscopic splenectomy

Objective To explore the safety and feasibility of robot splenectomy. Methods 65 patients undergoing robotic or laparoscopic splenectomy at No.940 Hospital of Chinese people′s Liberation Army Joint Service Support Force from Jan 2015 to Sep 2019 were analyzed retrospectively. Results The operation time and total hospitalization cost of robot spleen resection group and laparoscopic splenectomy group were[(167±34) min vs.(123±24) min, t=8.554, P=0.00]and (73 002±21 009) yuan vs. (42 095±9 999) yuan, (t=6.484, P=0.00), respectively. In laparoscopy group, 3 cases were converted to laparotomy. In the subgroup of splenic hilum thickness ≥5 cm, the intraoperative bleeding volume of robot group and laparoscopic group was (145±67) ml vs. (263±180) ml, (t=-2.195, P=0.04). There were significant differences in VAS score (3±1) vs. (4±1), (t=2.175, P=0.04). Conclusion Robotic splenectomy is safe and feasible. For patients with splenomegaly, robot surgery has more minimally invasive advantages than laparoscopy, but it is expensive and time-consuming. Key words: Splenectomy; Robotics; Laparoscopes

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中华普通外科杂志

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