国产机器人手术系统在甲状腺癌手术中应用的安全性与疗效OA北大核心CSTPCD
Safety and efficacy of using domestically manufactured robotic surgical system for thyroid cancer surgery
背景与目的:机器人手术系统在甲状腺手术中的应用有效推动了甲状腺微创外科的发展,目前应用最多是达芬奇机器人外科手术系统,但其高昂的设备成本限制了机器人甲状腺手术的开展.因此,本研究探讨国产机器人手术系统在甲状腺癌手术中应用的安全性和有效性,以期为临床开展提供参考. 方法:回顾性分析2023年5月-2023年10月中国人民解放军联勤保障部队第九六○医院甲状腺乳腺外科211例行甲状腺切除术的甲状腺乳头状癌患者临床资料,其中42例行图迈®腔镜手术机器人手术(国产机器人组),169例行达芬奇机器人手术(达芬奇机器人组),采用倾向评分匹配(PSM)平衡两组患者基线资料后,比较两组患者的手术与术后相关指标. 结果:所有患者手术均顺利完成,两组均未中转开放手术.PSM前,两组间性别差异有统计学意义(P＜0.05).按1∶1进行PSM后,两组各纳入41例患者,两组的基线资料差异均无统计学意义(均P＞0.05).与达芬奇机器人组比较,国产机器人组平均总手术时间、助手准备时间、术者手术时间明显延长(193.68 min vs.138.85 min,P=0.00;43.32 min vs.37.9 min,P=0.00;150.37 min vs.100.95 min,P=0.00),淋巴结清扫数量减少(10.41枚vs.8.32枚,P=0.03).两组患者的淋巴结阳性数量、术后引流量、术后引流时间、术后住院时间、术后并发症、疼痛评分、美容效果满意度及主刀医师评价的差异均无统计学意义(P＞0.05). 结论:国产机器人手术系统在有选择性甲状腺癌患者的治疗中安全有效,给患者提供了新的选择.
Background and Aims:The application of robotic surgery systems in thyroid surgery has effectively promoted the development of minimally invasive thyroid surgery.Currently,the most commonly used system is the Da Vinci robotic surgical system.However,its high equipment cost limits the widespread adoption of robotic thyroid surgery.Therefore,this study was performed to investigate the safety and efficacy of the domestically manufactured robotic surgical system in the treatment of thyroid cancer,so as to provide reference for its clinical application. Methods:The clinical data of 211 patients with thyroid papillary carcinoma who underwent thyroidectomy at the Department of Thyroid and Breast Surgery,the 960th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from May 2023 to October 2023 were retrospectively analyzed.Among them,42 patients underwent robotic surgery with the Tumai® robotic surgical system(domestic robot group),and 169 patients underwent surgery with the Da Vinci robotic system(Da Vinci robot group).After balancing the baseline data of the two groups of patients using propensity score matching(PSM),the surgical and postoperative outcomes of the two groups were compared. Results:All surgeries were successfully completed,and there were no conversions to open surgery in either group.Before PSM,there was a statistical difference in gender between the two groups(P＜0.05).After 1∶1 PSM,41 patients were included in each group,and there were no statistically significant differences in baseline data between the two groups(all P＞0.05).Compared with the Da Vinci robot group,the domestic robot group had significantly longer average total operative time,assistant preparation time,and surgeon operation time(193.68 min vs.138.85 min,P=0.00;43.32 min vs.37.9 min,P=0.00;150.37 min vs.100.95 min,P=0.00),and a reduced number of lymph node dissection(10.41 vs.8.32,P=0.03).There were no significant differences between the two groups in the number of lymph node metastases,postoperative drainage volume,postoperative drainage time,postoperative hospital stays,incidence of postoperative complications,pain score,cosmetic satisfaction results,and primary surgeon evaluation(all P＞0.05). Conclusion:The domestically manufactured robotic surgical system is safe and effective in the treatment of selective thyroid cancer patients,providing a new option for patients
周鹏;徐婧;刘永祥;朱见;王刚;王猛;郭英豪;陈岚清;贺青卿
中国人民解放军联勤保障部队第九六O医院甲状腺乳腺外科,山东济南 250031
临床医学
甲状腺肿瘤甲状腺切除术机器人手术
Thyroid NeoplasmsThyroidectomyRobotic Surgical Procedures
《中国普通外科杂志》 2024 (005)
753-761 / 9
山东省医药卫生科技发展计划基金资助项目(202204011069);中国人民解放军联勤保障部队医学重点学科基金资助项目.
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