机器人辅助腹腔镜与传统腹腔镜治疗复杂肾上腺肿瘤的手术效果比较

目的 比较达芬奇机器人辅助腹腔镜和传统腹腔镜治疗复杂肾上腺肿瘤的手术效果，探讨达芬奇机器人辅助腹腔镜切除复杂肾上腺肿瘤的临床应用前景。方法 收集上海交通大学医学院附属瑞金医院2016年3月至2019年3月收治的47例复杂肾上腺肿瘤患者资料，其中机器人辅助腹腔镜组25例，传统腹腔镜组22例。比较两组手术中转开放手术情况、手术时间、术中出血量、术后引流管留置时间、术后住院时间及住院费用。结果 机器人辅助腹腔镜组手术均获成功，传统腹腔镜组有2例手术中转开放手术。机器人辅助腹腔镜组手术时间与传统腹腔镜组相比差异无统计学意义[159（149，168）min vs 165（155，194）min，P>0.05]；机器人辅助腹腔镜组术中出血量少于传统腹腔镜组[350（250，475）mL vs 550（285，615）mL，P<0.05]，术后引流管留置时间和术后住院时间短于传统腹腔镜组[3（3，4）d vs 4（3，4）d，P<0.05；6（6，7）d vs 7（7，8）d，P<0.05]，而住院费用高于传统腹腔镜组[72 874.30（72 398.60，73 651.60）元vs 48 933.50（43 978.60，50 254.90）元，P<0.05]。结论 对于复杂性的肾上腺肿瘤，达芬奇机器人辅助腹腔镜手术存在一定的优势，在患者经济条件允许的情况下值得推广。

Robot-assisted laparoscopy and traditional laparoscopy in the treatment of complicated adrenal tumors: a comparison of surgical efficacy

Objective To compare the surgical efficacy of da Vinci robot-assisted laparoscopy and traditional laparoscopy in the treatment of complicated adrenal tumors, so as to explore the clinical prospects of da Vinci robot-assisted laparoscopic surgery for the diseases. Methods The clinical data of 47 patients with complicated adrenal tumors who were admitted to Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from Mar. 2016 to Mar. 2019 were collected, with 25 cases in robot-assisted laparoscopy group and 22 cases in traditional laparoscopy group. The two groups were compared in terms of conversion to open surgery, operation time, intraoperative blood loss, postoperative drainage tube drawing time, hospital stay and hospitalization expenses. Results The surgery was successfully completed in robot-assisted laparoscopy group, while there were two cases of conversion to open surgery in traditional laparoscopy group. The differences in operation time between the robot-assisted laparoscopy group and traditional laparoscopy group were not statistically significant (159 [149, 168] min vs 165 [155, 194] min, P>0.05). Compared with traditional laparoscopy group, robot-assisted laparoscopy group had significantly less intraoperative blood loss (350 [250, 475] mL vs 550 [285, 615] mL, P<0.05], earlier drainage tube removal (3 [3, 4] d vs 4 [3, 4] d, P<0.05) and shorter hospital stay (6 [6, 7] d vs 7 [7, 8] d, P<0.05). However, hospitalization expenses in robot-assisted laparoscopy group were significantly higher than those in the traditional laparoscopy group (72 874.30 [72 398.60, 73 651.60] yuan vs 48 933.50 [43 978.60, 50 254.90] yuan, P<0.05). Conclusion Da Vinci robot-assisted laparoscopy has its own advantages in the treatment of complicated adrenal tumors, which is worthy of promotion in patients who can afford.