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中华腔镜外科杂志(电子版) ›› 2018, Vol. 11 ›› Issue (01) : 43 -46. doi: 10.3877/cma.j.issn.1674-6899.2018.01.012

所属专题: 机器人手术 文献

论著

正常与超重患者的机器人和腹腔镜胃癌根治对比
刘新1, 李鹏1, 刘元圣1, 刘洪一1, 贾宝庆1,()   
  1. 1. 100853 北京,解放军总医院普通外二科
  • 收稿日期:2018-01-10 出版日期:2018-02-28
  • 通信作者: 贾宝庆
  • 基金资助:
    国家自然科学基金(81772929)

Comparison of robotic gastrectomy and laparoscopic gastrectomy in patients with normal weight and overweight

Xin Liu1, Peng Li1, Yuansheng Liu1, Hongyi Liu1, Baoqing Jia1,()   

  1. 1. Department 2 of General Surgery, the General Hospital of PLA, Beijing 100853, China
  • Received:2018-01-10 Published:2018-02-28
  • Corresponding author: Baoqing Jia
  • About author:
    Corresponding author: Jia Baoqing, Email:
引用本文:

刘新, 李鹏, 刘元圣, 刘洪一, 贾宝庆. 正常与超重患者的机器人和腹腔镜胃癌根治对比[J/OL]. 中华腔镜外科杂志(电子版), 2018, 11(01): 43-46.

Xin Liu, Peng Li, Yuansheng Liu, Hongyi Liu, Baoqing Jia. Comparison of robotic gastrectomy and laparoscopic gastrectomy in patients with normal weight and overweight[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(01): 43-46.

目的

比较机器人和腹腔镜辅助胃癌根治术在体质量指数正常和超重患者中的临床疗效。

方法

回顾分析解放军总医院普通外二科自2012年6月至2017年6月手术的515例胃癌患者的临床资料,其中机器人手术302例、腹腔镜手术213例,按照体质量指数<24 kg/m2和≥24 kg/m2分为体质量指数正常组和超重组,比较正常组和超重组的机器人和腹腔镜手术的围手术期结果。

结果

同腹腔镜手术比较,在正常组和超重组中,机器人手术均有手术时间长[(219.7 ± 40.3)min vs (190.1 ± 38.5)min、P<0.000,(238.9 ± 44.0)min vs (211.8 ± 43.8)min、P<0.000]和术中出血量少[(155.5 ± 198.0)ml vs (196.3 ± 172.6)ml、P<0.000,(166.6 ± 162.0)ml vs (209.4 ± 224.9)ml、P< 0.000]的特点,术后进流食时间、术后住院时间和并发症发生率比较无差异(均P> 0.05)。正常组机器人清扫淋巴结数更多[(26.0 ± 9.6)枚vs (21.8 ± 9.5)枚、P<0.000];超重组机器人和腹腔镜手术比较无统计学差异[(22.9 ± 7.2)枚vs (22.3 ± 9.5)枚、P=0.310]。

结论

机器人胃癌根治术在体质量指数正常组和超重组的患者中均安全、有效,同腹腔镜手术相比,机器人手术在正常组的患者中清扫淋巴结数多,或许具有一定优势。

Objective

To compare the surgical outcome of robotic and laparoscopic radical gastectomy in patients with normal weight and overweight.

Methods

From Jun. 2012 to Jun. 2017, a total of 515 patients with gastric cancer who underwent robotic gastrectomy (RG, n=302) or laparoscopic gastrectomy (LG, n=213) in our department were retrospectively analysed. Patients were categorized into normal weight(body mass index <24 kg/m2) or overweight (body mass index≥24 kg/m2) group. The perioperative outcomes of RG or LG were compared in the two groups.

Results

In both normal weight and overweight group, RG shown longer operation time [(219.7 ± 40.3)min vs (190.1 ± 38.5)min, P<0.000; (238.9 ± 44.0)min vs (211.8 ± 43.8)min, P<0.000] and less estimated blood loss[(155.5 ± 198.0)ml vs (196.3 ± 172.6)ml, P<0.000; (166.6 ± 162.0)ml vs (209.4 ± 224.9)ml, P<0.000] compared with LG, while there was no significant difference in time of eating liquid diet, postoperative stay and complication rate (P> 0.05). There were more retrieved lymph nodes in the normal weight group by RG [(26.0 ± 9.6) vs (21.8 ± 9.5), P<0.000]. However, it was not significantly different in the overweight group [(22.9 ± 7.2) vs (22.3 ± 9.5), P= 0.310].

Conclusions

RG is safe and effective in both normal weight and overweight group. RG may have the advantage of more retrieved lymph nodes in the normal weight group compared with LG.

表1 体质量指数正常组276例胃癌根治术患者的两组一般资料比较
表2 体质量指数超重组239例胃癌根治术患者的两组一般资料比较
表3 体质量指数正常组276例胃癌根治术患者的两组围手术期资料比较
表4 体质量指数超重组239例胃癌根治术患者的两组围手术期资料比较
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