Deimling Timothy A, Eldridge Jennifer L, Riley Kristin A, Kunselman Allen R, Harkins Gerald J
Division of Minimally Invasive GYN Surgery, Department of Obstetrics and Gynecology, Milton S Hershey Medical Center, Penn State University, Hershey, PA, USA.
Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Milton S Hershey Medical Center, Penn State University, Hershey, PA, USA.
Int J Gynaecol Obstet. 2017 Jan;136(1):64-69. doi: 10.1002/ijgo.12001. Epub 2016 Nov 3.
To compare the operative time between robot-assisted laparoscopic hysterectomies and standard laparoscopic hysterectomies.
A prospective, randomized controlled trial enrolled women aged 18-80 years attending Penn State Hershey Medical Center between April 23 and October 20, 2014 to undergo hysterectomy. Participants were randomized using a random number generator to undergo either robot-assisted or standard laparoscopic hysterectomy. The primary outcome was the total operative time (surgeon incision to surgeon stop, including robot docking time, if applicable). Intention-to-treat analyses were performed and the operative time was compared between the two treatments for non-inferiority, defined as a difference in operative time of no longer than 15 minutes.
There were 72 patients randomized to each treatment arm. The mean operative time was 73.9 minutes (median 67.0 minutes; interquartile range 59.0-83.0 minutes) in the robot-assisted hysterectomy group and 74.9 minutes (median 65.5 minutes; interquartile range 57.0-90.5 minutes) in the standard laparoscopic hysterectomy group. The upper bound of the 95% confidence interval of the difference in operative time was 6.6 minutes, below the 15-minute measure of non-inferiority.
When performed by a surgeon experienced in both techniques, the operative time for robot-assisted laparoscopic hysterectomy was non-inferior to that achieved with standard laparoscopic hysterectomy. CLINICALTRIALS.GOV: NCT02118974.
比较机器人辅助腹腔镜子宫切除术与标准腹腔镜子宫切除术的手术时间。
一项前瞻性随机对照试验纳入了2014年4月23日至10月20日在宾夕法尼亚州立大学赫尔希医学中心接受子宫切除术的18至80岁女性。参与者使用随机数字生成器随机接受机器人辅助或标准腹腔镜子宫切除术。主要结局是总手术时间(从外科医生切开至外科医生结束,如适用,包括机器人对接时间)。进行意向性分析,并比较两种治疗方法的手术时间是否非劣效,非劣效定义为手术时间差异不超过15分钟。
每个治疗组随机分配了72例患者。机器人辅助子宫切除术组的平均手术时间为73.9分钟(中位数67.0分钟;四分位间距59.0 - 83.0分钟),标准腹腔镜子宫切除术组为74.9分钟(中位数65.5分钟;四分位间距57.0 - 90.5分钟)。手术时间差异的95%置信区间上限为6.6分钟,低于15分钟的非劣效性衡量标准。
由两种技术都熟练的外科医生进行手术时,机器人辅助腹腔镜子宫切除术的手术时间不劣于标准腹腔镜子宫切除术。临床试验注册编号:NCT02118974。