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泌尿外科三维腹腔镜:100 例初步经验。

Three-dimensional laparoscopy in urology: Initial experience after 100 cases.

机构信息

University Medical Centre of Ho Chi Minh City, 215 Hong Bang Street, District 5, Ho Chi Minh City, Viet Nam.

University Medical Centre of Ho Chi Minh City, 215 Hong Bang Street, District 5, Ho Chi Minh City, Viet Nam.

出版信息

Asian J Surg. 2019 Jan;42(1):303-306. doi: 10.1016/j.asjsur.2018.04.012. Epub 2018 May 25.

Abstract

OBJECTIVE

To evaluate the efficacy of three-dimensional (3D) laparoscopy in urological procedures in a cohort study compared to two-dimensional (2D) laparoscopy.

METHODS

From October 2016 to August 2017, 100 patients underwent various urological procedures with 3D laparoscopy performed by a single experienced surgeon at the University Medical Centre of Ho Chi Minh City. The surgeon's subjective assessment of image quality, depth perception, ease of intra-corporeal suturing and knotting was recorded. The State-Trait Anxiety Inventory for Adults (STAI-6) short version was used to quantify aspects of stress experienced during each operative procedure. A subgroup of 73 complicated 3D laparoscopic procedures (nephron sparing nephrectomy, nephrectomy, adrenalectomy, pyeloplasty and ureterolithotomy) was compared to the same clinical parameter group of 74 two-dimensional laparoscopic procedures, performed by the same surgeon in the year before to define the differences in operative time, blood loss and time taken for critical surgical steps during the procedures.

RESULTS

Mean time of operation was 112.8 min ± 14.5 (range 45-210 min). Mean estimated blood loss was 54.7 mL ± 8.2 (range 20-100 mL). The surgeon's subjective assessment of image quality, depth perception, operative strain, ease of intra-corporeal suturing, and knotting, and hand-eye coordination was considered as good in 100% of cases. Mean score of STAI-6 was 11.6 ± 2.17 (range 10-22). Subgroup data analysis was all statistically better for 3D compared to 2D.

CONCLUSION

The use of 3D systems in laparoscopic urologic procedures resulted in better image quality and better surgeon performance with lower stress.

摘要

目的

通过队列研究,将三维(3D)腹腔镜与二维(2D)腹腔镜相比,评估其在泌尿外科手术中的疗效。

方法

2016 年 10 月至 2017 年 8 月,胡志明市医疗中心的一名经验丰富的外科医生对 100 名患者进行了各种泌尿外科手术,其中 3D 腹腔镜手术。记录外科医生对图像质量、深度感知、腔内缝合和打结难易程度的主观评估。使用成人状态-特质焦虑量表(STAI-6)短版本来量化每次手术过程中经历的压力方面。将 73 例复杂的 3D 腹腔镜手术(保肾肾切除术、肾切除术、肾上腺切除术、肾盂成形术和输尿管切开取石术)与同一年由同一位外科医生进行的 74 例二维腹腔镜手术的相同临床参数组进行比较,以定义手术过程中手术时间、失血量和关键手术步骤所需时间的差异。

结果

手术平均时间为 112.8±14.5 分钟(范围 45-210 分钟)。平均估计失血量为 54.7±8.2 毫升(范围 20-100 毫升)。外科医生对图像质量、深度感知、手术紧张、腔内缝合和打结、手眼协调的主观评估均为 100%的病例认为良好。STAI-6 的平均得分为 11.6±2.17(范围 10-22)。亚组数据分析显示,3D 组的所有数据均明显优于 2D 组。

结论

在腹腔镜泌尿外科手术中使用 3D 系统可提高图像质量和外科医生的手术表现,同时降低压力。

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