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达芬奇机器人辅助直肠癌根治术的效果观察

Effect of Da Vinci robot assisted radical resection of rectal cancer

    摘要
  • 摘要:
    目的 比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。
    方法 回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PSM), 最终将行达芬奇机器人辅助直肠癌根治术(达芬奇机器人组)、腹腔镜辅助直肠癌根治术(腹腔镜组)患者各51例纳入本研究。比较2组术中及术后情况，分析2组2年生存情况。
    结果 达芬奇机器人组手术时间长于腹腔镜组，术中失血量、术后24 h C反应蛋白及疼痛数字评分法评分低于腹腔镜组，术后拔尿管时间短于腹腔镜组，差异均有统计学意义(P < 0.05)。达芬奇机器人组术后并发症发生率为13.73%, 腹腔镜组为15.69%, 差异无统计学意义(P>0.05)。达芬奇机器人组、腹腔镜组中位生存时间分别为21.9、21.7个月，差异无统计学意义(χ2=0.495, P=0.482)。达芬奇机器人组2年生存率为82.35%(42/51), 腹腔镜组为76.47%(39/51), 差异无统计学意义(χ2=0.540, P=0.463)。
    结论 达芬奇机器人辅助直肠癌根治术的根治效果、远期疗效与腹腔镜辅助直肠癌根治术相近, 但前者更有利于降低术中失血量，缓解术后炎症及疼痛程度，并可促进患者泌尿功能的恢复。

     

    Abstract:
    Objective To compare the effect of Da Vinci robot assisted and laparoscopic assisted radical resection of rectal cancer.
    Methods The clinical data of 180 patients underwent Da Vinci robot assisted or laparoscopic assisted radical resection of rectal cancer were retrospectively analyzed. SPSS 22.0 software was used to perform 1 to 1 propensity score matching (PSM) for patients, and finally 51 cases with Da Vinci robot assisted radical resection of rectal cancer (Da Vinci robot group) and 51 cases with laparoscopic assisted radical resection of rectal cancer (laparoscopic group) were included in this study. The intraoperative and postoperative conditions were compared between the two groups, and the 2-year survival condition was analyzed in both groups.
    Results The operation time of the Da Vinci robot group was significantly longer than that of the laparoscopy group, while the intraoperative blood loss, the C reactive protein within 24 hours after operation and the score of the Numeric Rating Scale in the Da Vinci robot group were significantly lower than those in the time of removing urinary catheter after operation was shorter than the laparoscopic group (P < 0.05). The incidence rates of postoperative complications were 13.73% in the Da Vinci robot group and 15.69% in the laparoscopic group, and there was no significant difference between two groups (P>0.05). The median survival time of the Da Vinci robot group and the laparoscopic group were 21.9 and 21.7 months respectively, and there was no significant difference between two groups (χ2=0.495, P=0.482). The 2-year survival rate of the Da Vinci robot group was 82.35% (42/51), which showed no significant difference when compared to 76.47% (39/51) of the laparoscopic group (χ2=0.540, P=0.463).
    Conclusion Da Vinci robot assisted radical resection of rectal cancer can achieve the similar radical effect and long-term effect as laparoscopic assisted radical resection of rectal cancer, but the former is more conducive to reduce intraoperative blood loss, alleviate degrees of postoperative inflammation and pain, and promote the recovery of urinary function of patients.

     

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