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单部位机器人辅助与腹腔镜顺行双侧腹股沟淋巴结清扫术治疗阴茎癌的回顾性对照研究。

Single-position robot-assisted versus laparoscopic antegrade bilateral inguinal lymphadenectomy for penile cancer: A retrospective controlled study.

机构信息

Urology Center, Department of Urology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang Province, People's Republic of China.

Laboratory Medicine Center, Molecular Diagnosis Laboratory, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang Province, People's Republic of China.

出版信息

Asian J Surg. 2022 Aug;45(8):1530-1534. doi: 10.1016/j.asjsur.2022.03.025. Epub 2022 Mar 24.

Abstract

OBJECTIVES

The main purpose of this study was to compare the surgical strategy and clinical outcomes of single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy for penile cancer.

MATERIALS AND METHODS

21 patients were diagnosis with squamous cell carcinoma and identified from March 2010 to December 2020 in our department. Ten patients were received single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy (robot-assisted group), and eleven patients underwent laparoscopic inguinal lymphadenectomy (laparoscopic group). Preoperative physical examination and related auxiliary examinations all indicated bilateral inguinal lymph node enlargement, and there was no distant metastasis patient presented during the follow-up period.

RESULTS

There was no intraoperative conversion to open surgery. The operation time under robot-assisted group was 104 ± 13 min which was significantly shorter than laparoscopic group (136 ± 11 min, P < 0.01). The average number of lymph nodes was 22.2 ± 4.5 of both sides in robot-assisted group, which was statistically different compared with laparoscopic group (15.4 ± 3.1, p < 0.01). Moreover, there was significant difference of hospitalization cost between two groups (CNY 67429 ± 5586 vs 28582 ± 3774, P < 0.01). No differences in operation time, blood loss, and length of stay were recorded.

CONCLUSIONS

The single-position robotic assisted laparoscopic anterograde bilateral inguinal lymphadenectomy reveals with shorter operating time, and better surgical effect, Moreover, we prefer to no change the trocars layout and mechanical arm system during the operation.

摘要

目的

本研究的主要目的是比较单部位机器人辅助腹腔镜顺行双侧腹股沟淋巴结清扫术治疗阴茎癌的手术策略和临床结果。

材料与方法

2010 年 3 月至 2020 年 12 月期间,我科共诊断出 21 例鳞状细胞癌患者。其中 10 例患者接受单部位机器人辅助腹腔镜顺行双侧腹股沟淋巴结清扫术(机器人组),11 例患者接受腹腔镜腹股沟淋巴结清扫术(腹腔镜组)。术前体格检查和相关辅助检查均提示双侧腹股沟淋巴结肿大,随访期间无远处转移患者。

结果

无术中转为开放手术。机器人组的手术时间为 104±13 分钟,明显短于腹腔镜组(136±11 分钟,P<0.01)。机器人组双侧平均淋巴结数为 22.2±4.5 个,与腹腔镜组(15.4±3.1 个,P<0.01)相比有统计学差异。此外,两组的住院费用也存在显著差异(CNY 67429±5586 与 28582±3774,P<0.01)。两组在手术时间、出血量和住院时间方面无差异。

结论

单部位机器人辅助腹腔镜顺行双侧腹股沟淋巴结清扫术具有手术时间短、手术效果好的优点。此外,我们在手术过程中更倾向于不改变trocar 布局和机械臂系统。

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