The short-term treatment of robotic-assisted surgery versus laparoscopic surgery in endometrial cancer

doi:10.3877/cma.j.issn.1674-6899.2018.05.008

Abstract

Abstract:

Objective

The aim of this study was to compare short-term treatment between robotic-assisted versus laparoscopic surgery in patients with endometrial cancer, discuss the clinical advantages of robotic-assisted surgery in endometrial cancer.

Methods

The clinical data of 108 patients with endometrial from Jan. 2014 to Oct. 2017 in Gansu Provincial Hospital were retrospectively analyzed. There were 52 cases in robotic-assisted surgery group (RS) and 56 cases in laparoscopic surgery group (LS). Multivariable linear regressions were used to explore the difference between the RS and LS in terms of the operation time, estimated blood loss, length of hospital stay, lymph node counts. Multivariate Logistic regression model was used to evaluate the difference of transfer to ICU.

Results

In multivariable linear regressions, there was no significant difference in operative time, estimated blood loss, length of hospital stay (P>0.05). However, the counts of lymph node in RS were significant increased compared to LS (Coe.=13.25, 95%CI: 8.30-18.21, P<0.05). In multivariate Logistic regression, there was no difference in the rate of transfer to ICU between two groups(P>0.05).

Conclusions

Robotic-assisted surgery has a comparable clinical benefit as laparoscopic surgery and provides an advantage in lymph node dissection.

Key words: Robotic-assisted surgery, Laparoscopic surgery, Endometrial cancer

Lei Jiang, Ruiquan Zhou, Peijing Yan, Liang Yao, Tiankang Guo, Hui Cai, Kehu Yang, Hailin Wang. The short-term treatment of robotic-assisted surgery versus laparoscopic surgery in endometrial cancer[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2018, 11(05): 290-294.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2018.05.008

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2018/V11/I05/290

Figures/Tables 4

References 19

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人口统计学和临床资料		机器人组(52例)	腹腔镜组(56例)	P值
年龄(岁， ±s)		54.83 ± 9.12	52.16 ± 8.42	0.117^a
组织学[例(%)]		?	?	0.744^c
?	腺癌	50(46.3)	52(48.1)	?
?	其他	2(1.9)	4(3.7)	?
FIGO分期[例(%)]		?	?	0.045^c
?	ⅠA期	26(24.1)	33(30.6)	?
?	ⅠB期	14(13.0)	11(10.2)	?
?	Ⅱ期	12(11.1)	4(3.7)	?
?	Ⅲ期	0(0.0)	8(7.4)	?
合并症[例(%)]		?	?	?
?	高血压	24(22.2)	10(9.3)	0.002^c
?	糖尿病	9(8.3)	6(5.6)	0.322^c
?	妇科炎症疾病	41(38.0)	40(37.0)	0.374^c
?	其他妇科疾病	14(13.0)	23(21.3)	0.122^c
?	其他心血管疾病	2(1.9)	0(0.0)	0.299^c
贫血[例(%)]		?	?	0.475^c
?	无贫血	32(29.6)	40(37.0)	?
?	轻度贫血	14(13.0)	10(9.3)	?
?	中度贫血	6(5.6)	5(4.6)	?
?	重度贫血	0(0.0)	1(0.9)	?

人口统计学和临床资料		机器人组(52例)	腹腔镜组(56例)	P值
年龄(岁， ±s)		54.83 ± 9.12	52.16 ± 8.42	0.117^a
组织学[例(%)]		?	?	0.744^c
?	腺癌	50(46.3)	52(48.1)	?
?	其他	2(1.9)	4(3.7)	?
FIGO分期[例(%)]		?	?	0.045^c
?	ⅠA期	26(24.1)	33(30.6)	?
?	ⅠB期	14(13.0)	11(10.2)	?
?	Ⅱ期	12(11.1)	4(3.7)	?
?	Ⅲ期	0(0.0)	8(7.4)	?
合并症[例(%)]		?	?	?
?	高血压	24(22.2)	10(9.3)	0.002^c
?	糖尿病	9(8.3)	6(5.6)	0.322^c
?	妇科炎症疾病	41(38.0)	40(37.0)	0.374^c
?	其他妇科疾病	14(13.0)	23(21.3)	0.122^c
?	其他心血管疾病	2(1.9)	0(0.0)	0.299^c
贫血[例(%)]		?	?	0.475^c
?	无贫血	32(29.6)	40(37.0)	?
?	轻度贫血	14(13.0)	10(9.3)	?
?	中度贫血	6(5.6)	5(4.6)	?
?	重度贫血	0(0.0)	1(0.9)	?

手术结局指标	机器人组(52例)	腹腔镜组(56例)	P值
手术时间(min, ±s)	288.27 ± 93.478	237.50 ± 89.43	0.013^a
淋巴结清扫数目(枚， ±s)	30.00 ± 11.63	13.16 ± 12.99	<0.001^a
术中出血量(ml, ±s)	204.04 ± 153.23	179.82 ± 110.13	0.670^a
住院时间(d, ±s)	10.50 ± 3.91	10.71 ± 6.03	0.759^a
短期并发症(血栓性疾病)[例(%)]	7(6.5)	2(1.9)	0.131^b
引流管引流量(ml, ±s)	348.13 ± 300.95	415.00 ± 760.50	0.770^a
引流管放置时间(d, ±s)	4.69 ± 1.59	5.13 ± 2.57	0.631^a
术后首次通气时间(d， ±s)	3.27 ± 1.12	2.75 ± 1.32	0.002^a
术后肠道功能恢复时间(d, ±s)	3.38 ± 1.14	3.30 ± 1.16	0.231^a
转入ICU[例(%)]	4(3.7)	2(1.9)	0.607^b
中转开腹[例(%)]	0(0.0)	2(1.9)	0.496^b

手术结局指标	机器人组(52例)	腹腔镜组(56例)	P值
手术时间(min, ±s)	288.27 ± 93.478	237.50 ± 89.43	0.013^a
淋巴结清扫数目(枚， ±s)	30.00 ± 11.63	13.16 ± 12.99	<0.001^a
术中出血量(ml, ±s)	204.04 ± 153.23	179.82 ± 110.13	0.670^a
住院时间(d, ±s)	10.50 ± 3.91	10.71 ± 6.03	0.759^a
短期并发症(血栓性疾病)[例(%)]	7(6.5)	2(1.9)	0.131^b
引流管引流量(ml, ±s)	348.13 ± 300.95	415.00 ± 760.50	0.770^a
引流管放置时间(d, ±s)	4.69 ± 1.59	5.13 ± 2.57	0.631^a
术后首次通气时间(d， ±s)	3.27 ± 1.12	2.75 ± 1.32	0.002^a
术后肠道功能恢复时间(d, ±s)	3.38 ± 1.14	3.30 ± 1.16	0.231^a
转入ICU[例(%)]	4(3.7)	2(1.9)	0.607^b
中转开腹[例(%)]	0(0.0)	2(1.9)	0.496^b

变量		Coe.	95%CI	P值
手术时间(min)		?	?	?
?	腹腔镜组	参照	?	?
?	机器人组	6.09	－33.48～45.65	0.761
?	重度贫血	193.96	27.10～360.80	0.023
?	淋巴结清扫数目	1.86	0.47～3.23	0.009
术中出血量(ml)		?	?	?
?	腹腔镜组	参照	?	?
?	机器人组	16.03	－38.96～71.04	0.564
?	年龄	4.68	1.65～7.70	0.003
住院时间(d)		?	?	?
?	腹腔镜组	参照	?	?
?	机器人组	－1.36	－3.20～0.48	0.146
?	年龄	0.13	0.03～0.22	0.008
?	腺癌	－7.64	－11.44～－3.85	< 0.001
?	手术时间	0.01	0.00～0.02	0.001
?	术后首次通气时间	1.13	0.11～2.16	0.029
?	术后肠道恢复时间	－1.12	－2.05～－0.20	0.017
淋巴结清扫数目(枚)		?	?	?
?	腹腔镜组	参照	?	?
?	机器人组	13.25	8.30～18.21	<0.001

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