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机器人辅助腹腔镜子宫切除术与传统全腹腔镜子宫切除术术后基于电话的生活质量问卷

Postoperative Telephone-Based Questionnaire on Quality of Life after Robotic-Assisted Laparoscopic Hysterectomy versus Conventional Total Laparoscopic Hysterectomy.

作者信息

Elessawy Mohamed, Schneekloth Sarah, Günther Veronika, Maass Nicolai, Mettler Liselotte, Alkatout Ibrahim

机构信息

Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.

Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Luebeck, 23562 Luebeck, Germany.

出版信息

J Clin Med. 2020 Sep 2;9(9):2849. doi: 10.3390/jcm9092849.

Abstract

: The objective of the study was to evaluate the benefits of robotic-surgery for hysterectomy compared to conventional laparoscopy for benign indications. A specially prepared telephone-based questionnaire was used postoperatively. : All women ( = 155) undergoing total laparoscopic hysterectomy for benign indications either by the robotic-assisted procedure (RALH) or conventional laparoscopy (CL) between 1 January 2013 and 31 December 2017 at the Department of the Gynecology, University Hospitals, Campus Kiel, Germany, were eligible for analysis. Intra-operative and postoperative parameters affecting the patients' quality of life were assessed by a telephone-based questionnaire. The latter addressed postoperative pain, limitations of basic hygiene, daily activity, active pursuit of hobbies, sexual intercourse, and days of sick leave. All patients received the questionnaire by post at least three weeks prior to being contacted on the phone. : 78% of the contacted patients responded to the questionnaire; 96% ( = 115) of the patients said they would recommend the operation to other patients. Both groups needed 42 days to resume their regular hobbies. In whole 90.8% ( = 108) were total satisfied with the cosmetic result of the abdominal incision; the numbers in the respective groups were 80% (80% = 36) in RALH and 97.3% ( = 72) in CL. The difference was significant on the Chi-square test ( = 0.002). 5% ( = 7) were dissatisfied with the scar (13.3%; = 6) in the RALH group, and 1.4% ( = 1) in CL. In all 1.7 % of patients were dissatisfied with the position of the incisions; the respective numbers were 4.4 % ( = 2) in the RALH group and no patient in the CL group. 33% of patients experienced no limitations in regard of sexual intercourse after the operation. The median number of days taken to resume sexual intercourse after the operation was 56 days in the CL group, and 49 days in the RALH group. Nearly 30% ( = 25) were hesitant to resume intercourse. The median operating time was 145 min in the RALH group, which was significantly longer than the 117 min taken in the CL group ( < 0.001). : The RALH procedure was associated with some minor advantages for the patients according to the results, however it does not have major significant advantages, especially in regard of early restoration of sexual function, while the CL shows shorter operating times and similar limitation. Postoperative counseling of patients should be aligned to their fears and expectations in regard of sexual function.

摘要

本研究的目的是评估与传统腹腔镜手术相比,机器人手术用于良性指征子宫切除术的益处。术后使用了一份专门编制的电话调查问卷。:2013年1月1日至2017年12月31日期间,在德国基尔大学校园大学医院妇科接受机器人辅助手术(RALH)或传统腹腔镜手术(CL)进行良性指征全腹腔镜子宫切除术的所有女性(n = 155)均符合分析条件。通过电话调查问卷评估影响患者生活质量的术中及术后参数。后者涉及术后疼痛、基本卫生限制、日常活动、积极追求爱好、性生活以及病假天数。所有患者在电话联系前至少三周通过邮寄方式收到问卷。:78%的受访患者回复了问卷;96%(n = 115)的患者表示会向其他患者推荐该手术。两组患者均需要42天才能恢复其常规爱好。总体而言,90.8%(n = 108)的患者对腹部切口的美容效果完全满意;各小组中的数字分别为RALH组80%(80% = 36)和CL组97.3%(n = 72)。经卡方检验,差异具有统计学意义(P = 0.002)。5%(n = 7)的患者对瘢痕不满意(RALH组为13.3%;n = 6),CL组为1.4%(n = 1)。总体而言,1.7%的患者对切口位置不满意;RALH组相应数字为4.4%(n = 2),CL组无患者不满意。33%的患者术后在性生活方面没有受限。术后恢复性生活的天数中位数在CL组为56天,RALH组为49天。近30%(n = 25)的患者对恢复性生活犹豫不决。RALH组的中位手术时间为145分钟,显著长于CL组的117分钟(P < 0.001)。:根据结果,RALH手术对患者有一些小优势,但没有重大显著优势,尤其是在性功能早期恢复方面,而CL手术时间更短且受限情况相似。应对患者进行术后咨询,使其与对性功能的恐惧和期望相匹配。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4428/7565397/7b70ace3614f/jcm-09-02849-g001.jpg

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