摘要
目的:探索改良Trocar布局的经腹部入路机器人辅助单一体位技术在上尿路尿路上皮癌(UTUC)治疗中的疗效和安全性。方法:回顾性收集并分析2020年6月—2022年4月本院泌尿外科收治的75例UTUC患者临床资料。按照手术方式将其分为传统腹腔镜组和改良机器人辅助组,分别记录患者的基线特征、围手术期结果以及病理结果,同时记录术后短期并发症,随访观察患者总生存期和影像学无进展生存期。结果:两组患者手术均顺利完成,无中转开放或改变手术方式。改良机器人辅助组和传统腹腔镜组比较,两组患者基线资料之间无显著统计学差异。与传统腹腔镜组相比,改良机器人辅助组手术时间、术后住院时间更短。而在术中输血人数、术中出血量、术后管道留置时间、切缘阳性率、淋巴结阳性个数以及短期并发症方面两组无显著差异。短期随访结果同样提示改良机器人辅助组在总生存率和影像学无进展生存期方面与传统腹腔镜组一致,不存在显著差异。结论:改良Trocar布局的机器人辅助腹腔镜单一体位治疗UTUC短期疗效显著,并发症少,安全可靠,是一种可选择的手术方式。
Objective:To explore the efficacy and safety of robot-assisted laparoscopic surgery with modified Trocar layout and single-positioning technique in the treatment of upper urinary tract uroepithelial carcinoma(UTUC).Methods:Clinical data of 75 patients with UTUC who were admitted to our hospital from June 2020 to April 2022 were retrospectively collected and analyzed.The 75 patients were divided into the conventional laparoscopic surgery group and modified robot-assisted laparoscopic surgery group according to different surgical methods.Baseline characteristics,perioperative outcomes,pathological findings and short-term postoperative complications were observed and recorded.Follow-up was performed to observe the overall survival and progress free survival.Results:All surgeries were successfully completed.There was no statistically significant difference between the two groups in baseline characteristics of patients.Compared with the conventional laparoscopic group,the operative time and the postoperative hospital stay of the modified robot-assisted laparoscopic surgery group were shorter.By contrast,the modified robot-assisted laparoscopic surgery group had the same efficacy and safety as the conventional laparoscopic surgery group in terms of intraoperative blood transfusion rate,intraoperative bleeding,postoperative indwelling time,rate of positive surgical margins,positive lymph nodes,and short-term complications.The short-term follow-up results also indicated that the modified robot-assisted laparoscopic surgery was consistent with the conventional laparoscopic surgery in terms of overall survival and progression-free survival,and the differences were not statistically significant(P>0.05).Conclusion:Robot-assisted laparoscopic surgery with modified Trocar layout and single-positioning technique in the treatment of UTUS has significant short-term efficacy with few complications,which is a safe and reliable surgical option.
作者
于俊杰
温儒民
王军起
毛立军
YU Junjie;WEN Rumin;WANG Junqi;MAO Lijun(Department of Urology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
基金
国家卫生健康委能力建设和继续教育中心2020年度立项课题(GWJJ2020100303)。
