达芬奇机器人与腹腔镜手术治疗早期子宫内膜癌的对比分析

目的通过达芬奇机器人与腹腔镜手术治疗早期子宫内膜癌，探讨达芬奇机器人手术系统的安全性、可行性、优越性及临床应用价值。 方法回顾性总结吉林省肿瘤医院2014年6月至2016年3月实施的53例子宫内膜癌Ⅰ～Ⅱ期手术患者的临床资料及治疗效果，其中达芬奇机器人手术14例(机器人组)，腹腔镜手术39例(腹腔镜组)。 结果53例患者手术均顺利完成，无中转开腹及更改术式。机器人组、腹腔镜组的手术时间分别为(190.2 ± 53.4)min、(164.5 ± 60.8)min；术中出血量分别为(58.6 ± 28.7)ml、(126.3 ± 48.5)ml；手术并发症的发生率分别为0 (0/14)、7.7% (3/39)；术后疼痛时间分别为(26.4 ± 5.7)h、(31.3 ± 9.5)h；术后肠道功能恢复时间分别为(37.8 ± 16.9)h、(54.3 ± 15.2)h；术后48 h引流量分别为(153.7 ± 90.3)ml、(180.3 ± 54.8)ml；引流管留置时间分别为(98.2 ± 24.3)h、(126.3 ± 38.1)h；术后住院时间分别为(5.4 ± 1.5)d、(7.2 ± 2.1)d，两组比较，差异均有统计学意义(P<0.05)；膀胱功能恢复时间、腹部切口拆线时间、清扫淋巴结数目两组比较，差异均无统计学意义(P> 0.05)。患者均未出现大出血、感染、尿潴留等并发症。 结论达芬奇机器人手术系统应用于早期子宫内膜癌根治术安全可行，患者出血少、创伤小、术后疼痛时间短、胃肠道恢复时间短、引流管留置时间短、住院时间短且手术并发症低，值得临床推广应用。

Da Vinci robotic and laparoscopic surgery comparative analysis for the treatment of early endomertrial carcinoma

ObjectiveTo compare the clinical data of Da Vinci robotic and laparoscpic surgical treatment of early endometrial carcinoma, discuss the Da Vinci robotic safety, feasibility, advantages and clinical application value. MethodsA retrospective analysis of paients in Jilin Province Tumor Hospital from Jun. 2014 to Mar. 2016 undergoing was carried out, 53 patients (endometrial cancer Ⅰ - Ⅱ) surgery in patients with clinical data and treatment effect, including 14 cases of of DaVinci robotic group (robot), 39 cases of laparoscopic surgery group (laparoscopic). Results53 patients were operated successfully completed, no transfer laparotomy and change.robots, laparoscopic group of operating time(190.2 ± 53.4)min, (164.5 ± 60.8)min; intraoperative blood loss, respectively(58.6 ± 28.7)ml, (126.3 ± 48.5)ml; the incidence of complications was 0 (0 / 14), 7.7% (3 / 39); duration of postoperative pain (26.4 ± 5.7)h, (31.3 ± 9.5)h; time average recovery of intestinal function (37.8 ± 16.9)h, (54.3 ± 15.2)h; after 48 hours of ml (153.7 ± 90.3)ml, (180.3 ± 54.8)ml; drainage tube indwelling time (98.2 ± 24.3)h, (126.3 ± 38.1)h; the mean postoperative such confinement(5.4 ± 1.5)d, (7.2 ± 2.1)d, above the difference was statistically significant (P< 0.05); bladder function recovery time, take out stitches abdominal incision, number of lymph node excision, there was no significant difference(P> 0.05). The above cases appear no complications such as bleeding, infection, urinary retention. ConclusionsDa Vinci robotic in early endometrial cancer radical surgery safe and feasible, less bleeding, patients with small trauma, postoperative pain time is short, short recovery time of gastrointestinal tract and indwelling drainage tube time, average hospitalization days shorter, and low complications, worthy of clinical popularization and application.