机器人辅助食管癌根治术与胸腹腔镜食管癌根治术的近远期临床疗效对比

    Comparison of Short-Term and Long-Term Clinical Effects of Robot-Assisted Minimally Invasive Esophagectomy and Video-Assisted Minimally Invasive Esophagectomy

    • 摘要:
      目的 比较机器人辅助食管癌根治术与胸腹腔镜食管癌根治术的近、远期临床疗效,包括手术疗效、术后并发症发生率、术后近、远期疼痛及长期生存情况,进一步确定机器人辅助食管癌根治术的临床价值。
      方法 收集中国人民解放军南部战区总医院心胸外科2022年6月至2023年6月间收治并接受机器人辅助食管癌根治术的27例食管癌患者设为观察组,与同时期接受胸腹腔镜食管癌根治术的39例患者(对照组)进行对比,对两组患者的围手术期资料、术后并发症(肺部感染、吻合口瘘、声音嘶哑、乳糜胸)发生情况、术后近远期疼痛及长期生存情况(复发或转移、死亡)等临床资料进行对比。
      结果 与对照组相比,观察组患者的淋巴结清扫数量增加、术中出血量减少、声音嘶哑率显著下降,两组差异有统计学意义(P<0.05);观察组相较于对照组R0切除率更高,吻合口瘘及乳糜胸发生率更低,术后近期疼痛程度升高、远期疼痛改善,两组差异无统计学意义(P>0.05)。两组患者术后一年生存情况差异无统计学意义(P>0.05)。
      结论 机器人辅助食管癌根治术的手术效果确切,术后并发症发生率更低,并不影响患者远期生活质量及长期生存,值得临床推广。

       

      Abstract:
      Objective To compare the short-term and long-term clinical effects of robot-assisted minimally invasive esophagectomy and video-assisted minimally invasive esophagectomy, including surgical efficacy, incidence of postoperative complications, postoperative short-term and long-term pain and long-term survival, to further determine the clinical value of robot-assisted radical resection of esophageal cancer.
      Methods A total of 27 patients with esophageal cancer admitted and received robot-assisted minimally invasive esophagectomy in the Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA from June 2022 to June 2023 were collected and set as the observation group. The results were compared with 39 patients who received video-assisted minimally invasive esophagectomy in the same period (control group). The perioperative data, postoperative complications (pulmonary infection, anastomotic fistula, hoarseness, chylothorax), short-term and long-term postoperative pain and long-term survival (recurrence or metastasis, death) were compared between the two groups.
      Results Compared with the control group, the number of lymph node dissection, the amount of intraoperative blood loss and the rate of hoarseness decreased significantly in the observation group (P < 0.05). Compared with the control group, the observation group had a higher R0 resection rate, lower incidence of anastomotic leakage and chylothorax, higher short-term postoperative pain and long-term pain improvement, but there was no significant difference between the two groups (P < 0.05). There was no significant difference in survival between the two groups one year after surgery (P < 0.05).
      Conclusion Robot-assisted minimally invasive esophagectomy is effective, the incidence of postoperative complications is lower, and has no effect on the long-term quality of life and long-term survival of patients, which is worthy of clinical promotion.

       

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