Patzkowsky Kristin E, As-Sanie Sawsan, Smorgick Noam, Song Arleen H, Advincula Arnold P
Montefiore Medical Center, Centennial Women's Center, Bronx, NY 10467, USA.
JSLS. 2013 Jan-Mar;17(1):100-6. doi: 10.4293/108680812X13517013317914.
We compared the perioperative outcomes of hysterectomy performed by robotic (RH) versus laparoscopic (LH) routes for benign indications using the Dindo-Clavien scale for classification of the surgical complications.
Retrospective chart review of all patients who underwent robotic (n=288) and laparoscopic (n=257) hysterectomies by minimally invasive surgeons at the University of Michigan from March 2001 until June 2010.
Age, body mass index, operative time, and estimated blood loss were not statistically different between groups. The RH subgroup had a larger uterine weight (LH 186.4±130.6 g vs RH 234.9±193.9 g, P=.001), higher prevalence of severe adhesions (13.2% vs 23.3%, respectively, P=.003), and stage III-IV endometriosis (4.7% vs 15.3%, respectively, P<.05). There were no differences in the rates of Dindo-Clavien grade I, grade II, and grade III surgical complications between the RH and LH groups (9.7%, 13.2%, and 3.1%, respectively, in the RH group vs 6.2%, 9.3%, and 5.8%, respectively, in the LH group, P>.05). However, the rates of urinary tract infection were higher in the RH group (LH 2.7% vs RH 6.9%, P=.02), whereas the conversion to laparotomy rate was higher in the LH group (LH 6.2% vs RH 1.7%, P=.007).
Perioperative outcomes for laparoscopic and robotic hysterectomy for benign indications appear to be equivalent.
我们使用Dindo-Clavien分级系统对手术并发症进行分类，比较了机器人辅助子宫切除术（RH）与腹腔镜子宫切除术（LH）治疗良性疾病的围手术期结局。
对2001年3月至2010年6月在密歇根大学由微创外科医生实施机器人辅助子宫切除术（n = 288）和腹腔镜子宫切除术（n = 257）的所有患者进行回顾性病历审查。
两组患者的年龄、体重指数、手术时间和估计失血量无统计学差异。机器人辅助子宫切除术亚组的子宫重量更大（LH组为186.4±130.6 g，RH组为234.9±193.9 g，P = 0.001），重度粘连的发生率更高（分别为13.2%和23.3%，P = 0.003），III-IV期子宫内膜异位症的发生率也更高（分别为4.7%和15.3%，P < 0.05）。机器人辅助子宫切除术组与腹腔镜子宫切除术组在Dindo-Clavien I级、II级和III级手术并发症发生率方面无差异（机器人辅助子宫切除术组分别为9.7%、13.2%和3.1%，腹腔镜子宫切除术组分别为6.2%、9.3%和5.8%，P > 0.05）。然而，机器人辅助子宫切除术组的尿路感染发生率更高（腹腔镜子宫切除术组为2.7%，机器人辅助子宫切除术组为6.9%，P = 0.02），而腹腔镜子宫切除术组的中转开腹率更高（腹腔镜子宫切除术组为6.2%，机器人辅助子宫切除术组为1.7%，P = 0.007）。
腹腔镜子宫切除术和机器人辅助子宫切除术治疗良性疾病的围手术期结局似乎相当。
