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目的探讨机器人辅助手术与传统Ivor-Lewis食管癌根治术的短期疗效。方法 2015年1~9月,同一外科团队手术治疗36例食管癌,其中传统手术19例,机器人辅助手术17例。2组一般资料差异无统计学意义。回顾性比较2组手术相关资料、术后短期疗效的差异。结果机器人组手术时间长于传统组[(333.5±85.0)min vs.(203.9±24.8)min,t=6.357,P=0.000];手术出血量机器人组为(182.3±78.9)ml,传统组为(195.3±149.2)ml,差异无统计学意义(t=-0.319,P=0.752)。2组均R0切除,切端阴性。食管标本长度机器人组为(8.2±2.1)cm,传统组为(8.6±1.6)cm,差异无统计学意义(t=-0.654,P=0.518);淋巴结清扫数量机器人组为(17.4±7.7)枚,传统组为(20.0±9.1)枚,差异无统计学意义(t=-0.913,P=0.367)。术后住院时间机器人组显著少于传统组[(9.8±2.0)d vs.(12.6±5.5)d,t=-2.076,P=0.046]。术后并发症机器人组2例,传统组5例,差异无统计学意义(P=0.408)。2组术后30天内均无死亡病例。结论机器人辅助Ivor-Lewis手术的根治性与传统手术相当,术后恢复较传统手术快,并发症不多于传统手术,其短期疗效有待进一步大样本研究验证。
Objective To investigate the short-term curative effect of robotic assisted surgery and traditional Ivor-Lewis radical resection of esophageal cancer. Methods From January to September 2015, 36 cases of esophageal cancer were treated by the same surgical team, including 19 cases of traditional surgery and 17 cases of robot assisted surgery. There was no significant difference between the two groups in general data. Retrospective comparison of the two groups of surgical data, short-term efficacy after the difference. Results The operation time of robotic group was longer than that of the conventional group [(333.5 ± 85.0) min vs. (203.9 ± 24.8) min, t = 6.357, P = 0.000] 195.3 ± 149.2) ml, the difference was not statistically significant (t = -0.319, P = 0.752). 2 groups were R0 resection, cut ends negative. The length of the esophageal specimens was (8.2 ± 2.1) cm in the robot group and (8.6 ± 1.6) cm in the traditional group, with no significant difference (t = -0.654, P = 0.518). The number of lymphadenectomy robotic group was (17.4 ± 7.7) The traditional group was (20.0 ± 9.1) pieces, the difference was not statistically significant (t = -0.913, P = 0.367). There were significantly fewer postoperative hospital stay robot groups than those in the conventional group [(9.8 ± 2.0) d vs. (12.6 ± 5.5) days, t = -2.076, P = 0.046]. 2 cases of postoperative complications robot group, 5 cases of traditional group, the difference was not statistically significant (P = 0.408). No deaths occurred in the two groups within 30 days after operation. Conclusion The robot-assisted Ivor-Lewis surgery has the same curative effect as traditional surgery. The postoperative recovery is faster than traditional surgery and the complications are not more than those of traditional surgery. The short-term curative effect needs further large sample study.