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机器人辅助子宫切除术与经阴道子宫切除术治疗良性疾病的前瞻性研究

Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study.

作者信息

Carbonnel M, Abbou H, N'guyen H T, Roy S, Hamdi G, Jnifen A, Ayoubi J M

机构信息

Service de Gynécologie Obstetrique, Hôpital Foch, Faculté de Médecine Paris Ouest, 92150 Suresnes, France.

出版信息

Minim Invasive Surg. 2013;2013:429105. doi: 10.1155/2013/429105. Epub 2013 Jul 7.

Abstract

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease. Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients' demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery. Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group (132.1 ± 5.7 versus 75.3 ± 6.7 min; P < 0.0001). Blood loss and length of hospital stay were significantly reduced: 47 ± 7 versus 125 ± 20 ml; P < 0.01, and 2.4 ± 0.1 versus 3.3 ± 0.2 days; P < 0.0001, respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications. Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

摘要

目的。开展一项前瞻性研究,比较阴道子宫切除术(VH)与机器人辅助子宫切除术(RH)治疗良性妇科疾病的效果。材料与方法。纳入2010年3月至2012年3月期间因良性疾病接受子宫切除术的所有患者。从病历中收集患者的人口统计学数据及手术前后的结果。术后2个月还进行了问卷调查。结果。RH组纳入60例患者,VH组纳入34例患者。RH组的手术时间显著更长(132.1±5.7分钟对75.3±6.7分钟;P<0.0001)。失血量和住院时间显著减少:分别为47±7毫升对125±20毫升;P<0.01,以及2.4±0.1天对3.3±0.2天;P<0.0001。RH组患者在术后第1天和第2天报告的疼痛较轻,与VH组相比,镇痛水平较低。在转为剖腹手术率、术中或术后并发症方面未发现差异。结论。机器人辅助子宫切除术似乎可减少失血量、术后疼痛和住院时间,但与更长的手术时间和更高的成本相关。RH的具体适应证仍有待确定。

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Robotic surgery in gynecology: an updated systematic review.妇科机器人手术:一项最新的系统评价。
Obstet Gynecol Int. 2011;2011:852061. doi: 10.1155/2011/852061. Epub 2011 Nov 28.

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