Clinical comparison of robotic-assisted and traditional laparoscopic radical hysterectomy

doi:10.3877/cma.j.issn.1674-6899.2016.04.009

Abstract

Abstract:

Objective

By comparing the clinical data of traditional laparoscopic radical hysterectomy (LRHPL) and robotic-assisted laparoscopic radical hysterectomy, to explore the advantages of robotic surgery system in the application of LRHPL.

Methods

A retrospective analysis of patients undergoing robotic-assisted LRHPL (n=23) was carried out in Jilin Province Tumor Hospital Department 2 of Gynecologic Oncology from Oct. 2014 to Dec. 2015. 30 patients undergoing LRHPL (n=30) during the same period was selected as the control group. For the caparison of the two groups, the operation duration, blood loss during operation, 24 hours postoperative drainage volume, postoperative bowel recovery time and the length of postoperative hospitalization were observed.

Results

Compared with LRHPL group, the patients of robotic laparoscopic group showed significantly reduced blood loss, shorter postoperative bowel recovery time and hospital stay; while their average operation duration was slightly longer. The two sets of data were significantly different [(60.8 ± 38.3) ml vs (79.7 ± 49.4) ml, (1.89 ± 0.35) d vs (2.06 ± 0.26) d, (8.89 ± 3.35) d vs (11.2 ± 5.18) d, (152.0 ± 27.7) min vs (144.0 ± 35.2) min](P<0.05). The comparison of 24 hours postoperative drainage volume between the two groups didn′t show statistically significance (P>0.05).

Conclusions

Robotic-assisted laparoscopy is feasible and safe, worthy of promotion for less bleeding, less damage, faster recovery, less pain for patients and shortens the mean length of stay.

Key words: Robotic-assisted, Laparoscopy, Radical hysterectomy

Fangfang Guo, Dongqing Li, Jinhong Qi, Yunlan Huang, Li Qi, Jing Wang, Liying Liu, Yong Yuan. Clinical comparison of robotic-assisted and traditional laparoscopic radical hysterectomy[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(04): 224-227.

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https://zhqjwkzz.cma-cmc.com.cn/EN/Y2016/V09/I04/224

Figures/Tables 3

References 15

1	Nezhat C, Saberi NS, Shahmohamady B, et al. Robotic-assisted laparoscopy in gynecological surgery [J]. J Socie Laparoend Surgeons, 2006, 10 (3): 317-320.
2	Bedient CE, Magrina JF, Noble BN, et al. Comparison of robotic and laparoscopic myomectomy [J]. Am J Obstet Gynecol, 2009, 201 (6): 566-567.
3	Shemer J. Laparascopic surgery and robotic-guided surgery [J]. Harefuah, 2009, 148 (3): 169-170, 210.
4	黄志华，屠蕊沁. 达芬奇机器人辅助妇科手术的临床分析[J]. 现代妇产科进展，2014, 25(11): 895-897.
5	Shashoua AR, Gill D, Locher SR. Robotic-assisted total laparoscopic hysterectomy versus conventional total laparoscopic hysterectomy [J]. JSLS, 2009, 13 (3): 364-369.
6	Fred Brody, Nathan G, Richards.Review of robotic versus conventional laparoscopic surgery [J]. Surg Endose, 2014, 28 (5): 1413-1424.
7	Payne TN, Dauterive FR, Pitter MC, et al. Robotically assisted hysterectomy in patients with large uteri outcomes in five community practices [J]. Obstet Gynecol, 2010, 115 (3): 535-542.
8	沈周俊，王先进. 达芬奇机器人手术系统在泌尿外科领域的应用现状 [J]. 中华医学杂志，2012, 92 (8): 505-506.
9	何晓琴，Mukesh Parekh. 机器人辅助腹腔镜子宫全切术41例报告[J]. 中国微创外科杂志，2011, 10(6): 489-495.
10	Nezhat C, Lavie O, Hsu S, et al. Robotic-assisted laparoscopic myomectomy compared with standard laparoscopic myomectomy: a retrospective matched control study [J]. Fertil Steril, 2009, 91 (2): 556-559.
11	Veljovich DS, Paley PJ, Dreshcer CW, et al. Robotic surgery in gynecologic oncology: program initiation and outcomes after the first year with comparison with laparotomy for endometrial cancer staging [J]. Am J Obstet Gynecol, 2008, 198 (6): 679.
12	丁晓萍，刘蕊，刘媛媛. 达芬奇机器人辅助卵巢子宫内膜异位囊肿手术8例临床分析 [J]. 中国妇产科临床杂志，2010, 11 (6): 447-448.
13	Magrina JF, Kho RM, Weaver AL, et al. Robotic radical hysterectomy: comparison with laparoscopy and laparotomy [J]. Gynecol Oncol, 2008, 109 (1): 86-91.
14	Segaert A, Traen K, Van Trappen P, et al. Robot-assiterd radical hysterectomy in cervical carcinoma: the belgain experience [J]. International Journal of Gynecological Cancer, 2015, 25 (9): 1690-1696.
15	孙小单，袁勇. 机器人及传统腹腔镜全子宫切除术的临床比较[J/CD]. 中华腔镜外科杂志：电子版，2015, 8 (2): 103-106.

组别	例数	年龄(岁)	身高 (m)	体质量 (kg)	病灶 < 4 cm(例数)	病灶 > 4 cm(例数)
腹腔镜组	30	45.9 ± 6.9	1.61 ± 0.18	59.6 ± 6.2	19	11
机器人组	23	46.5 ± 8.0	1.58 ± 0.27	57.5 ± 8.2	15	8
P值	?	> 0.05	> 0.05	> 0.05	> 0.05	> 0.05

组别	例数	年龄(岁)	身高 (m)	体质量 (kg)	病灶 < 4 cm(例数)	病灶 > 4 cm(例数)
腹腔镜组	30	45.9 ± 6.9	1.61 ± 0.18	59.6 ± 6.2	19	11
机器人组	23	46.5 ± 8.0	1.58 ± 0.27	57.5 ± 8.2	15	8
P值	?	> 0.05	> 0.05	> 0.05	> 0.05	> 0.05

组别	例数	手术时间(min)	术中出血量(ml)	清扫淋巴结数目 (枚)
机器人组	23	152.0±27.7^a	60.8±38.3^a	22.1±4.1
腹腔镜组	30	144.0±35.2	79.7±49.4	21.6±3.4
P值	?	<0.05	< 0.05	> 0.05

组别	例数	手术时间(min)	术中出血量(ml)	清扫淋巴结数目 (枚)
机器人组	23	152.0±27.7^a	60.8±38.3^a	22.1±4.1
腹腔镜组	30	144.0±35.2	79.7±49.4	21.6±3.4
P值	?	<0.05	< 0.05	> 0.05

组别	例数	术后24 h引流量(ml)	术后留置尿管时间 (d)	术后首次排气时间(d)	术后住院时间(d)
腹腔镜组	30	142.2 ± 14.6	13.8 ± 4.18	2.06 ± 0.26	11.2 ± 5.18
机器人组	23	143.5 ± 16.4	12.9 ± 4.27	1.89 ± 0.35^a	8.89 ± 3.35^a
P值	?	> 0.05	> 0.05	< 0.05	< 0.05

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