Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, No. 707, Chung-Yang Rd., Sec. 3, Hualien, 970, Taiwan.
Institute of Medical Sciences, Tzu Chi University, Hualien, 970, Taiwan.
J Robot Surg. 2024 Sep 23;18(1):345. doi: 10.1007/s11701-024-02105-3.
Gynecologic surgery with minimally invasive method using robotic or laparoscopic techniques has gained popularity for reducing perioperative discomfort and length of hospital stay. However, the debate over postoperative pain superiority between traditional laparoscopy and robotic surgery persist. This study compared the postoperative pain of patients within 24 h of robotic (RM) and laparoscopic myomectomy (LM). This retrospective cohort study included 24 and 53 patients who underwent RM and LM, respectively, between January 2019 and July 2023. The primary outcomes were the postoperative pain levels of patients within 24 h and the use and dosage of postoperative analgesia. Additional perioperative analgesia, including long-acting non-steroidal anti-inflammatory drugs (Dynastat) and abdominal nerve block, was also recorded. The secondary outcomes were blood loss and hospitalization duration. The patient characteristics were similar between the groups. Factors that could potentially increase pain, such as the number of ports (p < 0.0001), additional procedures (p = 0.0195), operative time (p < 0.0001), number of myomas (p = 0.0057), and the largest myoma size (p = 0.0086), were significantly higher in the RM group than in the LM group. However, there were no significantly different in the postoperative visual analog scale pain scores, use and dosage of ketorolac and opioid, and use of Dynastat and nerve block between the groups. Hospitalization duration and intraoperative blood loss were similar between the groups. RM and LM offer comparable postoperative pain outcomes, emphasizing the importance of patient-specific factors in decision-making regarding myomectomy techniques.
采用机器人或腹腔镜技术的微创妇科手术因其能减少围手术期不适和住院时间而受到青睐。然而，传统腹腔镜手术和机器人手术术后疼痛优势的争论仍在继续。本研究比较了机器人辅助子宫肌瘤切除术（RM）和腹腔镜子宫肌瘤切除术（LM）患者术后 24 小时内的疼痛情况。本回顾性队列研究纳入了 2019 年 1 月至 2023 年 7 月期间分别接受 RM 和 LM 的 24 例和 53 例患者。主要结局是患者术后 24 小时内的疼痛水平以及术后镇痛药物的使用和剂量。还记录了额外的围手术期镇痛，包括长效非甾体抗炎药（地佐辛）和腹部神经阻滞。次要结局是出血量和住院时间。两组患者的特征相似。有潜在增加疼痛风险的因素，如手术端口数量（p<0.0001）、附加手术（p=0.0195）、手术时间（p<0.0001）、肌瘤数量（p=0.0057）和最大肌瘤大小（p=0.0086）在 RM 组显著高于 LM 组。然而，两组患者术后视觉模拟评分疼痛、酮咯酸和阿片类药物的使用和剂量、地佐辛和神经阻滞的使用均无显著差异。两组患者的住院时间和术中出血量相似。RM 和 LM 提供了相似的术后疼痛结局，这强调了在选择子宫肌瘤切除术技术时，患者具体因素的重要性。
