机器人与腹腔镜直肠癌根治术后患者功能恢复及生活质量的对比研究

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摘要 目的: 比较机器人与腹腔镜直肠癌根治术的术后并发症、术后肛门功能、泌尿功能及生活质量的差异。方法: 收集2021年1月至2022年7月于中南大学湘雅三医院行直肠手术的179例患者临床资料,通过纳入排除标准后,将患者分为机器人组（37例）和腹腔镜组（44例）,进行长达1年时间的随访,比较两组患者术后并发症、肛门功能、泌尿功能和生活质量的差异。结果: 两组患者无中转开腹、无术中死亡病例。术后病理资料、手术情况、围手术期恢复情况,差异无统计学意义,机器人组术后1年并发症总发生率低于腹腔镜组;吻合口瘘、肠梗阻、术后1年再次手术发生率,差异无统计学意义;两组患者症状评分、功能评分和总体健康状况评分术前比较,差异无均统计学意义;术后1月,机器人组的经济困难评分高于腹腔镜组,机器人组的整体恶心呕吐症状评分高于腹腔镜组,术后3月,机器人组较腹腔镜组,疲倦、便秘症状评分、身体功能、总的健康状况,均更具优势;术后6月和术后12月,机器人组患者均有着比腹腔镜组患者更好的总体健康水平;机器人组住院费用高于腹腔镜组。结论: 与腹腔镜手术相比,机器人手术治疗直肠癌在降低术后并发症的发生率和改善患者术后生活质量上具有优势。

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	黄飞龙
	李亮
	张翼
	胡桂
	郭一航
	龙飞
	林昌伟
	李小荣

关键词 ：直肠癌, 腹腔镜, 机器人手术, 生活质量, 泌尿功能, 肛门功能

Abstract：Objective To compare the differences in postoperative complications, postoperative anal function, urinary function, and quality of life between robotic and laparoscopic radical rectal cancer surgery. Methods The clinical data of 179 patients who underwent rectal surgery in Xiangya Third Hospital of Central South University from January 2021 to July 2022 were collected, and the patients were divided into the robotic group (37 patients) and laparoscopic group (44 patients) through the inclusion and exclusion criteria and were followed up up up for up to one year, comparing the differences in postoperative complications, anal function, urinary function and quality of life of the two groups of patients. Results There were no intermediate openings and no intraoperative deaths in the two groups. Postoperative pathological data, surgical situation, perioperative recovery, the difference was not statistically significant , the total incidence of complications in the robotic group was lower than that of the laparoscopic group at 1 year after surgery ; anastomotic fistula, intestinal obstruction, and the incidence of reoperation at 1 year after surgery, the difference was not statistically significant ; the symptom scores, functional scores, and the overall health scores of the patients of the two groups were higher than that of the laparoscopic group at 1 month after surgery . Comparison, the difference was not statistically significant; 1 month after surgery, the economic hardship score of the robotic group was higher than that of the laparoscopic group , and the overall nausea and vomiting symptom score of the robotic group was higher than that of the laparoscopic group ; 3 months after surgery, the robotic group had a greater advantage over the laparoscopic group in terms of fatigue, constipation symptom scores, physical function, and overall health status; at 6 months postoperatively and 12 months postoperatively, patients in the robotic group had better overall health than patients in the laparoscopic group; and the cost of hospitalisation was higher in the robotic group than in the laparoscopic group. Conclusion Compared with laparoscopic surgery, robotic surgery for rectal cancer has advantages in reducing the incidence of postoperative complications and improving patients' postoperative quality of life.

Key words： rectal cancer laparoscopy robotic surgery quality of life urinary function anal function

收稿日期: 2023-12-30

中图分类号:

R735.3+7

基金资助:湖南省科技创新计划项目-青年科技人才项目（2022RC1218）

通讯作者: 林昌伟,E-mail ：linchangwei@csu.edu.cn

引用本文:

黄飞龙, 李亮, 张翼, 胡桂, 郭一航, 龙飞, 林昌伟, 李小荣. 机器人与腹腔镜直肠癌根治术后患者功能恢复及生活质量的对比研究[J]. 湖南师范大学学报(医学版), 2024, 21(2): 66-72. HUANG Feilong, LI Liang, ZHANG Yi, HU Gui, GUO Yihang, LONG Fei, LIN Changwei, LI Xiaorong. Comparative study of functional recovery and quality of life in patients after robotic versus laparoscopic radical rectal cancer surgery. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(2): 66-72.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2024/V21/I2/66

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