良性妇科疾病中机器人单孔子宫切除术与机器人多孔子宫切除术的比较：临床和手术结局的回顾性对比

Robotic single-port hysterectomy versus robotic multisite hysterectomy in benign gynecologic diseases: A retrospective comparison of clinical and surgical outcomes.

作者信息

Park So Yun, Cho Eun Hye, Jeong Kyungah, Yoo Hae Kyung, Lee Jung Hun, Moon Hye-Sung

机构信息

Department of Obstetrics and Gynecology, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea.

Department of Obstetrics and Gynecology, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, South Korea.

出版信息

J Obstet Gynaecol Res. 2023 Nov;49(11):2746-2752. doi: 10.1111/jog.15778. Epub 2023 Aug 27.

DOI:10.1111/jog.15778

PMID:37635443

Abstract

BACKGROUND

This study aimed to compare clinical and surgical outcomes of robotic single-port hysterectomy (RSPH) using the da Vinci® SP surgical system and robotic multisite hysterectomy (RMSH) with the da Vinci Xi system in benign gynecologic disease.

METHODS

The retrospective study included 134 patients who underwent RSPH or RMSH between November 2019 and December 2020. Total operation time, amount of blood loss, and the change in hemoglobin (Hb) after surgery and the weight of the removed uteri were also measured. Data on complications such as post-operative fever and length of hospitalization were also compared and analyzed.

RESULTS

There was no significant difference in the total operation time between the two groups, although the operation time was slightly longer in the RSPH group. Results in the RSPH group were superior to the RMSH group in docking time and wound incision time (1.67 ± 0.79 vs. 5.46 ± 2.25 min, p-value <0.01; 6.48 ± 4.29 vs. 9.10 ± 4.64 min, p-value <0.01, respectively). On the other hand, wound suture time took longer in the RSPH group (18.12 ± 5.66 vs. 10.69 ± 3.18 min, p-value <0.01). The weights of the removed specimens were higher in the RMSH group (302.64 ± 190.56 vs. 369.24 ± 181.70 g, p-value <0.04). The amount of blood loss during surgery and the difference in hemoglobin (Hb) before and after surgery were less in the RSPH group (97.39 ± 113.79 vs. 224.93 ± 152.29 mL, p-value <0.01, 1.51 ± 1.08 vs. 2.54 ± 1.08 g/dL, p-value <0.01). When considering the weight difference as a correction between the two surgical groups (because there were many heavier samples in the RMSH group), the blood loss of the RSPH group was also less than that of the RMSH group by 115.95 ± 23.78 mL (p-value <0.01).

CONCLUSIONS

On the basis of our data, the robotic hysterectomy using the da Vinci SP surgical system might be feasible and safe, even if the hysterectomy is complex, and comparable to robotic multisite surgery by the da Vinci Xi system.

摘要

背景

本研究旨在比较使用达芬奇®SP手术系统的机器人单孔子宫切除术（RSPH）和使用达芬奇Xi系统的机器人多部位子宫切除术（RMSH）在良性妇科疾病中的临床和手术效果。

方法

这项回顾性研究纳入了2019年11月至2020年12月期间接受RSPH或RMSH的134例患者。还测量了总手术时间、失血量、术后血红蛋白（Hb）变化以及切除子宫的重量。对术后发热和住院时间等并发症数据也进行了比较和分析。

结果

两组的总手术时间无显著差异，尽管RSPH组的手术时间略长。RSPH组在对接时间和伤口切开时间方面的结果优于RMSH组（分别为1.67±0.79分钟对5.46±2.25分钟，p值<0.01；6.48±4.29分钟对9.10±4.64分钟，p值<0.01）。另一方面，RSPH组的伤口缝合时间更长（18.12±5.66分钟对10.69±3.18分钟，p值<0.01）。RMSH组切除标本的重量更高（302.64±190.56克对3�9.24±181.70克，p值<0.04）。RSPH组手术中的失血量以及手术前后血红蛋白（Hb）的差异更小（97.39±113.79毫升对224.93±152.29毫升，p值<0.01；1.51±1.08克/分升对2.54±1.08克/分升，p值<0.01）。当将重量差异作为两个手术组之间的校正因素考虑时（因为RMSH组中有许多更重的样本），RSPH组的失血量也比RMSH组少115.95±23.78毫升（p值<0.01）。