体质量指数对机器人辅助腹腔镜全子宫切除术的影响

目的:探讨体质量指数(Body mass index,BMI)对机器人辅助腹腔镜全子宫切除术的影响。方法:收集中国医科大学附属第一医院妇科行机器人辅助腹腔镜全子宫切除术的131例患者的临床资料,根据体质量指数的不同,将患者分为正常体重组(BMI<24kg/m²)、超重组(BMI为24~28kg/m²)和肥胖组(BMI≥28kg/m²),比较三组患者年龄、术前有内科合并症(高血压、冠心病或糖尿病)患者的占比、手术时间、中转开腹率,以及术后血红蛋白下降程度、排气时间、术后住院日等。结果:超重组和肥胖组术前有内科合并症(高血压、冠心病或糖尿病)患者的比例超过正常体重组。而在年龄、手术时间、术后血红蛋白下降程度、排气时间、术后住院日方面,体重正常组与超重组及肥胖组比较,差异无统计学意义(P>0.05),所有患者无1例中转开腹。结论:机器人辅助腹腔镜全子宫切除术对于超重及肥胖的患者是安全、可行的,在患者基础条件不佳的情况下,可以获得与正常体重患者相似的术中及术后结局,是一种可以选择的手术方式。

Influence of body mass index on robot-assisted laparoscopic hysterectomy

Objective:To study the effect of body mass index(BMI)on robot-assisted laparoscopic hysterectomy(RALH).Methods:The clinical data of 131 patients who underwent RALH in the department of gynecology of the First Hospital of China Medical University were collected and divided into normal weight group(BMI<24kg/m²),overweight group(BMI≥24kg/m² and<28kg/m²)and obese group(BMI≥28kg/m²)according to their body mass indexes.Age,proportion of patients with medical comorbidities(hypertension,coronary heart disease or diabetes)before surgery,operation time,conversion rate to laparotomy,decreasing of hemoglobin after surgery,time of exhaust,length of hospital stays after surgery of the three groups were compared and analyzed.Results:The proportion of patients with medical comorbidities in the overweight group and obese group was higher than that in the normal weight group.In terms of age,operation time,postoperative hemoglobin decline,time of exhaust,length of hospital stay after surgery,no significant differences were found among the three groups(P>0.05).No conversion to laparotomy happened.Conclusion:RALH is safe and feasible for overweight and obese patients,which can achieve similar intraoperative and postoperative outcomes in patients under poor basic conditions to normal weight patients.RALH is an alternative surgical procedure for overweight and obese patients.