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机器人辅助腹腔镜与传统腹腔镜在附件肿物处理中的比较。

Comparison of robotic-assisted and conventional laparoscopy in the management of adnexal masses.

作者信息

El Khouly N I, Barr R L, Kim B B, Jeng C J, Nagarsheth N P, Fishman D A, Nezhat F R, Gretz H F, Chuang L T

机构信息

Department of Obstetrics and Gynecology, Menoufia University, Menufia, Egypt.

Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

出版信息

J Minim Invasive Gynecol. 2014 Nov-Dec;21(6):1071-4. doi: 10.1016/j.jmig.2014.05.007. Epub 2014 May 24.

Abstract

STUDY OBJECTIVE

To compare the outcome of robotic-assisted laparoscopy vs conventional laparoscopy in the management of ovarian masses.

DESIGN

Retrospective cohort (Canadian Task Force classification II-3).

SETTING

Academic medical centre in the northeast United States.

PATIENTS

Retrospective medical record review of 71 consecutive patients with presumed benign ovarian masses.

INTERVENTION

Robotic-assisted laparoscopy in 30 patients with presumed benign ovarian masses was compared with conventional laparoscopy in 41 patients.

MEASUREMENTS AND MAIN RESULTS

Operative outcomes including operative time, estimated blood loss, length of hospital stay, and complications were recorded. Standard statistical analysis was used to compare the outcomes in the 2 groups. Mean (SD) operative time in the robotic group was 1.95 (0.63) hours, which was significantly longer than in the conventional laparoscopic group, 1.28 (0.83) hours (p = .04). Estimated blood loss in the robotic group was 74.52 (56.23) mL, which was not significantly different from that in the conventional laparoscopic group, 55.97 (49.18) mL. There were no significant differences in length of hospital stay between the robotic and conventional laparoscopic groups: 1.20 (0.78) days and 1.48 (0.63). Conversion to laparotomy was not necessary in either group of patients. Intraoperative and postoperative complications were similar between the 2 groups.

CONCLUSION

Robotic-assisted laparoscopy is a safe and efficient technique for management of various types of ovarian masses. However, conventional laparoscopy is preferred for management of ovarian masses because of shorter operative time. Prospective studies are needed to evaluate the outcomes of robotic-assisted laparoscopic management of benign and malignant ovarian neoplasms.

摘要

研究目的

比较机器人辅助腹腔镜手术与传统腹腔镜手术治疗卵巢肿块的效果。

设计

回顾性队列研究(加拿大工作组分类II-3)。

地点

美国东北部的学术医疗中心。

患者

对71例疑似良性卵巢肿块的连续患者进行回顾性病历审查。

干预措施

将30例疑似良性卵巢肿块患者的机器人辅助腹腔镜手术与41例患者的传统腹腔镜手术进行比较。

测量指标及主要结果

记录手术结果,包括手术时间、估计失血量、住院时间和并发症。采用标准统计分析比较两组的结果。机器人组的平均(标准差)手术时间为1.95(0.63)小时,明显长于传统腹腔镜组的1.28(0.83)小时(p = 0.04)。机器人组的估计失血量为74.52(56.23)毫升,与传统腹腔镜组的55.97(49.18)毫升无显著差异。机器人组和传统腹腔镜组的住院时间无显著差异:分别为1.20(0.78)天和1.48(0.63)天。两组患者均无需转为开腹手术。两组的术中及术后并发症相似。

结论

机器人辅助腹腔镜手术是治疗各种类型卵巢肿块的一种安全有效的技术。然而,由于手术时间较短,传统腹腔镜手术更适合治疗卵巢肿块。需要进行前瞻性研究来评估机器人辅助腹腔镜手术治疗良性和恶性卵巢肿瘤的效果。

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