The First Clinical Medical College of Lanzhou University, Lanzhou 730000, PR China; Department of Obstetrics and Gynecology, Gansu Provincial Hospital, Lanzhou 730000, PR China; Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, PR China; Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou 730000, PR China.
Institution of Clinical Research and Evidence Based Medicine, Gansu Provincial Hospital, Lanzhou 730000, PR China.
Asian J Surg. 2020 Jan;43(1):347-353. doi: 10.1016/j.asjsur.2019.05.003. Epub 2019 Jun 19.
To compare robot-assisted surgery and conventional laparoscopy for gynecologic oncology regarding intra- and post-operative outcomes.
A retrospective study was performed on consecutive patients with gynecologic oncology from February 2014 to October 2017 at Gansu Provincial Hospital, China. Multivariable linear and logistic regression models were performed to explore the difference between two surgeries in the surgical outcomes after adjusting for potential confounders.
276 women were included in this study: 153 robot-assisted surgeries and 123 conventional laparoscopies. The multivariable linear regression model showed that robot-assisted surgery was longer operative time [coefficient (coef), 33.76; 95% CI, 12.47, 55.05; P = 0.002) ], higher lymph node yield (coef, 10.41; 95% CI, 7.47, 13.35; P < 0.001), shorter time to early post-operative feeding (coef, -1.09; 95% CI, -1.33, -0.84; P < 0.001) and less post-operative drainage volume (coef, -368.77; 95% CI, -542.46, -195.09; P < 0.001) than conventional laparoscopy. However, no difference was observed between the two surgeries regarding the estimated blood loss (P > 0.05). The multivariable logistic regression model showed that post-operative complications were similar between robot-assisted surgery and conventional laparoscopy (P > 0.05).
Robot-assisted surgery was superior to conventional laparoscopy regarding intra- and post-operative outcomes for gynecologic oncology.
比较机器人辅助手术与传统腹腔镜手术治疗妇科恶性肿瘤的围手术期结局。
对 2014 年 2 月至 2017 年 10 月在甘肃省人民医院连续就诊的妇科恶性肿瘤患者进行回顾性研究。采用多变量线性和逻辑回归模型，在调整潜在混杂因素后，探讨两种手术方式在手术结局方面的差异。
本研究共纳入 276 例患者：153 例行机器人辅助手术，123 例行传统腹腔镜手术。多变量线性回归模型显示，机器人辅助手术的手术时间更长[系数（coef）为 33.76；95%置信区间（CI）为 12.47，55.05；P=0.002]，淋巴结清扫量更多（coef，10.41；95%CI，7.47，13.35；P<0.001），术后早期开始喂养的时间更早（coef，-1.09；95%CI，-1.33，-0.84；P<0.001），术后引流总量更少（coef，-368.77；95%CI，-542.46，-195.09；P<0.001），但两组间术中出血量无差异（P>0.05）。多变量逻辑回归模型显示，机器人辅助手术与传统腹腔镜手术的术后并发症发生率相似（P>0.05）。
机器人辅助手术在妇科恶性肿瘤的围手术期结局方面优于传统腹腔镜手术。
