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机器人辅助子宫肌瘤切除术与开腹子宫肌瘤切除术后的手术结果

Postoperative outcomes after robotic versus abdominal myomectomy.

作者信息

Griffin Leanne, Feinglass Joe, Garrett Ariane, Henson Anne, Cohen Leeber, Chaudhari Angela, Lin Alexander

机构信息

Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

JSLS. 2013 Jul-Sep;17(3):407-13. doi: 10.4293/108680813X13693422521557.

Abstract

BACKGROUND AND OBJECTIVES

Differences in postoperative outcomes comparing robotic-assisted laparoscopic myomectomy (RALM) with abdominal myomectomy (AM) have rarely been reported. The objective of this study was to compare surgical, quality-of-life, and residual fibroid outcomes after RALM and AM.

METHODS

Consecutive patients who underwent RALM (n = 16) were compared with AM patients (n = 23) presenting with a uterine size of <20 weeks. Study patients participated in a telephone interview at 6 weeks and underwent a no-cost ultrasonographic examination at 12 weeks after surgery to obtain quality-of-life and residual fibroid outcomes. Medical records were reviewed to obtain surgical outcomes.

RESULTS

Longer operative times (261.1 minutes vs 124.8 minutes, P < .001) and a 3-fold unfavorable difference in operative efficiency (73.7 g vs 253.0 g of specimen removed per hour, P < .05) were observed with RALM compared with AM. Patients undergoing RALM had shorter lengths of hospital stay (1.5 days vs 2.7 days, P < .001). Reduction of patient symptoms and overall satisfaction were equal. RALM patients were more likely to be back to work within 1 month (85.7% vs 45.0%, P < .05). Residual fibroid volume in the RALM group was 5 times greater than that in the AM group (17.3 cm(3) vs 3.4 cm(3), P < .05).

CONCLUSION

RALM and AM were equally efficacious in improving patient symptoms. Although operative times were significantly longer with RALM, patients had a quicker recovery, demonstrated by shortened lengths of stay and less time before returning to work. However, greater residual fibroid burden was observed with RALM when measured 12 weeks after surgery.

摘要

背景与目的

比较机器人辅助腹腔镜子宫肌瘤切除术(RALM)与开腹子宫肌瘤切除术(AM)术后结局差异的报道较少。本研究旨在比较RALM和AM术后的手术情况、生活质量及肌瘤残留情况。

方法

将连续接受RALM手术的患者(n = 16)与子宫大小<20周的AM患者(n = 23)进行比较。研究对象在术后6周接受电话访谈,并在术后12周接受免费超声检查,以获取生活质量和肌瘤残留情况。查阅病历以获取手术结局。

结果

与AM相比,RALM的手术时间更长(261.1分钟对124.8分钟,P <.001),手术效率存在3倍的不利差异(每小时切除标本量73.7克对253.0克,P <.05)。接受RALM的患者住院时间更短(1.5天对2.7天,P <.001)。患者症状减轻情况和总体满意度相当。RALM患者更有可能在1个月内恢复工作(85.7%对45.0%,P <.05)。RALM组的肌瘤残留体积是AM组的5倍(17.3立方厘米对3.4立方厘米,P <.05)。

结论

RALM和AM在改善患者症状方面同样有效。虽然RALM的手术时间明显更长,但患者恢复更快,表现为住院时间缩短和恢复工作前的时间减少。然而,术后12周测量时,RALM的肌瘤残留负担更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0783/3771759/0e45c80771f5/jls0031331480001.jpg

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