机器人辅助腹腔镜下前列腺癌根治性切除术改良仰卧位与常规体位的对照研究

目的:探讨第四代达芬奇机器人Xi系统辅助腹腔镜下前列腺癌根治性切除手术采取改良仰卧位的优势。方法:选取2019年12月—2021年1月在贵州省人民医院接受达芬奇机器人Xi系统辅助腹腔镜下前列腺癌根治性切除手术的90例患者为研究对象,按手术顺序随机将研究对象分为三组,分别为对照组A、对照组B和观察组C,每组各30例。对照组A采取常规头低脚高截石位,对照组B采用头低脚高"人"字形体位,观察组C采用改良仰卧位。比较三组手术体位摆放用时、手术用时、术中失血量及术中并发症的发生率。结果:所有手术均顺利完成,手术用时、术中失血量及相关术中并发症的发生率差异无统计学意义(P>0.05)。但采用设计改良仰卧体位摆放时间较常规采取截石位与"人"字形体位短(P<0.05)。结论:达芬奇手术机器人Xi系统辅助腹腔镜下前列腺癌根治性切除术中采用改良仰卧位,能够缓解常规体位拆卸托腿架带来的体力消耗,缩短摆放体位时间,预防常规体位术中可能带来的压力性损伤与术中并发症,值得推广。

Comparative study of modified supine position and conventional position in robot-assisted laparoscopic radical prostatectomy

Objective:To explore the advantages of modified supine position in laparoscopic radical prostatectomy assisted by Da Vinci Xi surgical system.Methods:90 patients who underwent laparoscopic radical prostatectomy assisted by Da Vinci Xi surgical system in Guizhou Provincial People’s Hospital from December 2019 to January 2021 were selected.90 patients were randomly divided into control group A,control group B and observation group C based on their surgical sequences,with 30 cases in each group.Routine lithotomy-trendelenburg position were adopted in the control group A,split-leg position in the control group B,and the modified supine position in the observation group C.The positioning time,operating time,intraoperative blood loss and incidence of intraoperative complications of the three groups were compared.Results:All the surgeries were successfully completed.No significant difference on operation time,intraoperative blood loss and the incidence of related intraoperative complications were found(P>0.05).However,the positioning time of the modified supine position was shorter than that of the conventional lithotomy position and split-leg position(P<0.05).Conclusion:The modified supine position in laparoscopic radical resection of prostate cancer assisted by Da Vinci Xi surgical system could decrease the physical output caused by the removal of leg support in conventional position,shorten the positioning time,and prevent the possible pressure injury and intraoperative complications in conventional position,which is worth of popularization.