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机器人与标准腹腔镜治疗子宫内膜异位症的比较。

Robotic versus standard laparoscopy for the treatment of endometriosis.

机构信息

Center for Minimally Invasive and Robotic Surgery, Stanford University Medical Center, Palo Alto, California 94304, USA.

出版信息

Fertil Steril. 2010 Dec;94(7):2758-60. doi: 10.1016/j.fertnstert.2010.04.031. Epub 2010 May 26.

Abstract

OBJECTIVE

To compare robot assisted laparoscopic platform to standard laparoscopy for the treatment of endometriosis.

DESIGN

A retrospective cohort controlled study.

SETTING

Tertiary referral center.

PATIENT(S): Seventy-eight reproductive aged women.

INTERVENTION(S): Robot assisted or standard laparoscopy for the treatment of endometriosis between January 2008 and January 2009.

MAIN OUTCOME MEASURE(S): Operative time, estimated blood loss, hospitalization time, intraoperative and postoperative complications.

RESULT(S): Seventy-eight patients underwent treatment of endometriosis, 40 by robot assisted laparoscopy and 38 by standard laparoscopy. The two groups were matched for age, body mass index (BMI), stage of endometriosis, and previous abdominal surgery. Mean operative time with the robot was 191 minutes (range 135-295 minutes) compared with 159 minutes (range 85-320 minutes) during standard laparoscopy. There were no significant differences in blood loss, hospitalization, intraoperative or postoperative complications. There were no conversions to laparotomy.

CONCLUSION(S): Both robot assisted laparoscopic and standard laparoscopic treatment of endometriosis have excellent outcomes. The robotic technique required significantly longer surgical and anesthesia time, as well as larger trocars.

摘要

目的

比较机器人辅助腹腔镜平台与标准腹腔镜治疗子宫内膜异位症的效果。

设计

回顾性队列对照研究。

地点

三级转诊中心。

患者

78 名育龄妇女。

干预措施

2008 年 1 月至 2009 年 1 月期间,分别采用机器人辅助腹腔镜或标准腹腔镜治疗子宫内膜异位症。

主要观察指标

手术时间、估计失血量、住院时间、术中及术后并发症。

结果

78 例患者接受了子宫内膜异位症的治疗,其中 40 例采用机器人辅助腹腔镜,38 例采用标准腹腔镜。两组患者的年龄、体重指数(BMI)、子宫内膜异位症分期和既往腹部手术史相匹配。机器人辅助腹腔镜组的平均手术时间为 191 分钟(范围 135-295 分钟),而标准腹腔镜组为 159 分钟(范围 85-320 分钟)。两组患者的失血量、住院时间、术中或术后并发症无显著差异。无中转开腹。

结论

机器人辅助腹腔镜和标准腹腔镜治疗子宫内膜异位症均有良好的效果。机器人技术需要更长的手术和麻醉时间,以及更大的套管。

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