摘要
目的探讨机器人辅助下食管裂孔疝修补术和传统腹腔镜下食管裂孔疝修补术治疗食管裂孔疝的短期临床效果。方法回顾性分析2021年1月至2022年1月在新疆维吾尔自治区人民医院微创疝和腹壁外科行食管裂孔疝修补术的56例患者的临床资料。男性32例,女性24例,年龄(59.7±10.7)岁(范围:28~75岁)。根据手术方式不同分为腹腔镜组(27例)和机器人组(29)例。采用t检验、Wilcoxon秩和检验或χ2检验比较两组围手术期情况、住院时间和手术前后症状改善情况。结果56例患者均顺利完成手术,无中转开腹或改变术式,无手术相关严重并发症发生。机器人组术中出血量少于腹腔镜组[M(IQR)][20(110)ml比40(80)ml,Z=-4.098,P<0.01]。机器人组和腹腔镜组的手术时间[(111.7±33.6)min比(120.4±35.0)min,t=-0.943,P=0.350]和术后住院时间相当[(3.9±1.4)d比(4.7±1.9)d,t=-1.980,P=0.053]。术后随访12个月无手术并发症及复发,机器人组胃食管反流病问卷量表症状评分从术前的10.8±2.8降至术后的6.5±0.6,腹腔镜组从术前的10.6±2.1降至术后的6.3±0.6,但两组间不同的手术方式对评分变化的影响无差异(t=0.030,P=0.976)。结论机器人辅助下食管裂孔疝修补术较传统腹腔镜下食管裂孔疝修补术的术中出血量少,术后恢复快,近期效果良好。
Objective To analyze the short-term clinical effects of robot-assisted and laparoscopic repair of the hiatal hernia.Methods The clinical data of 56 patients underwent minimally invasive hiatal hernia repair from January 2021 to January 2022 in the Department of Minimally Invasive Surgery,Hernias and Abdominal Wall Surgery,People′s Hospital of Xinjiang Uygur Autonomous Region were retrospectively analyzed.There were 32 males and 24 females,aging(59.7±10.7)years(range:28 to 75 years).All patients were divided into laparoscopy group(n=27)and robot group(n=29)according to surgical procedures.Perioperative conditions,hospital stay,and improvement in symptoms before and after surgery were compared between the two groups by the t test,Wilcoxon rank-sum test andχ2 test.Results All surgical procedures were successfully completed,without conversion to laparotomy or change in operation mode.There were no serious complications related to the operation.The intraoperative blood loss of the robot group was less than that of the laparoscopic group(M(IQR)):(20(110)ml vs.40(80)ml,Z=-4.098,P<0.01).The operation time((111.7±33.6)minutes vs.(120.4±35.0)minutes,t=-0.943,P=0.350)and hospitalization time((3.9±1.4)days vs.(4.7±1.9)days,t=-1.980,P=0.053)of the robot group and the laparoscopic group were similar.Follow-up for 12 months after the operation showed no postoperative complications and recurrence.The score of the health-related quality of life questionnaire for gastroesophageal reflux disease in the robot group decreased from 10.8±2.8 before the operation to 6.5±0.6 after the operation,and that in the laparoscopic group decreased from 10.6±2.1 before the operation to 6.3±0.6 after the operation.There was no difference in the influence of different surgical methods on the change in score(t=0.030,P=0.976).Conclusion Compared with laparoscopic repair of the hiatal hernia,robot-assisted hiatal hernia repair has the advantages of less bleeding,rapid postoperative recovery and good short-term effect.
作者
麦麦提艾力·麦麦提明
多力坤·牙生
伊尔夏提江·艾尼瓦尔
李义亮
艾克拜尔·艾力
王俭
克力木
Maimaitiaili Maimaitiming;Duolikun Yasheng;Yierxiatijiang Ainiwaer;Li Yiliang;Aikebaier Aili;Wang Jian;Kelimu(Department of Minimally Invasive Surgery,Hernias and Abdominal Wall Surgery,People′s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery,Research Institute of General and Minimally Invasive Surgery,Xinjiang Uygur Autonomous Region,Urumqi 830001,China;Graduate School,Xinjiang Medical University,Urumqi 830054,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2023年第6期498-502,共5页
Chinese Journal of Surgery
基金
国家卫生健康委医药卫生科技发展研究中心微创手术临床应用规范研究项目(WA2020RW25)
新疆维吾尔自治区科技支疆项目计划(2019E0287)。
