Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Arch Gynecol Obstet. 2012 Feb;285(2):435-40. doi: 10.1007/s00404-011-1999-2. Epub 2011 Jul 22.
To compare clinical and effectiveness outcomes between robotic-assisted laparoscopic myomectomy (RALM) and abdominal myomectomy (AM).
Records were reviewed for the first 27 RALM procedures at our institution. Age, BMI, insurance status, race, uterine size, and operative indication were used to select comparable patients who had undergone AM. Clinical and efficiency outcomes were compared stratifying for uterine size, specimen weight, and matched propensity scores.
IV hydromorphone use was significantly lower for RALM (P < 0.01), with no significant differences in blood loss or complications. RALM patients had significantly shorter hospital stays; however, total hospital charges were higher (P < 0.0001). This likely reflects longer operating room time (P < 0.0001), which was magnified as specimen size increased (P < 0.0001).
RALM patients require less IV hydromorphone, have shorter hospital stays, and have generally equivalent clinical outcomes compared with AM patients. Additionally, as specimen size increased, the operative efficiency of RALM decreased compared with AM.
比较机器人辅助腹腔镜子宫肌瘤剔除术（RALM）和开腹子宫肌瘤剔除术（AM）的临床和疗效结果。
对我院首例 27 例 RALM 手术的病历进行回顾性分析。根据年龄、BMI、保险状况、种族、子宫大小和手术指征，选择了接受 AM 的可比患者。根据子宫大小、标本重量和匹配倾向评分对临床和效果结果进行分层比较。
RALM 组 IV 氢吗啡酮的使用明显减少（P<0.01），而出血量和并发症无明显差异。RALM 组患者的住院时间明显缩短；但总住院费用较高（P<0.0001）。这可能反映了手术时间较长（P<0.0001），随着标本大小的增加而放大（P<0.0001）。
与 AM 患者相比，RALM 患者需要较少的 IV 氢吗啡酮，住院时间更短，且具有相当的临床疗效。此外，随着标本大小的增加，RALM 的手术效率与 AM 相比降低。
