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目的比较分析达芬奇机器人手术系统应用于直肠癌手术的安全性及近期疗效。方法回顾性分析中国人民解放军总医院2012年1月至2015年12月行达芬奇机器人直肠癌前切除术的78例直肠癌病人(机器人组)的临床资料,以同期行腹腔镜直肠癌前切除术的156例直肠癌病人(腹腔镜组)作为对照,对比分析临床病理因素及近期疗效。结果机器人组较腹腔镜组术中出血明显减少[(53.9±12.4)m L vs.(75.7±58.6)m L,P=0.000],但手术时间延长[(208.5±118.5)min vs.(173.7±35.4)min,P=0.003]。两组病人术后排气时间、恢复进食时间、留置导尿时间、淋巴结清扫数、术后并发症、术后住院时间等方面差异均无统计学意义(P>0.05)。机器人组手术费用明显高于腹腔镜组[(8.4±1.3)万元vs.(7.0±1.3)万元,P=0.004]。结论达芬奇机器人直肠癌前切除术安全可行,与腹腔镜手术具有相同的近期疗效,远期疗效须进一步研究。
Objective To compare and analyze the safety and short-term efficacy of Da Vinci robotic surgery system in rectal cancer surgery. Methods The clinical data of 78 rectal cancer patients (robotic group) undergoing Da Vinci robot rectal cancer resection from January 2012 to December 2015 were retrospectively analyzed. The patients undergoing laparoscopic rectal cancer 156 patients with resection of rectal cancer patients (laparoscopic group) as a control, comparative analysis of clinical and pathological factors and short-term efficacy. Results Compared with the laparoscopic group, the hemorrhage rate in the robot group was significantly lower than that in the laparoscopic group [(53.9 ± 12.4) m L vs. (75.7 ± 58.6) m L, P = 0.000], but the operative time was prolonged [(208.5 ± 118.5) min vs. (173.7 ± 35.4) min, P = 0.003]. There was no significant difference in postoperative exhaust time, recovery time, indwelling catheterization time, number of lymph node dissection, postoperative complications and postoperative hospital stay in both groups (P> 0.05). The cost of robotic surgery was significantly higher than that of the laparoscopic group [(8.4 ± 1.3) million vs. (7.0 ± 1.3) million, P = 0.004]. Conclusions Da Vinci robot prerectrectomy is safe and feasible, and has the same short-term curative effect as laparoscopic surgery. The long-term curative effect needs further study.