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Robotic versus laparoscopic distal pancreatectomy: a retrospective single-center study



Robotic versus laparoscopic distal pancreatectomy: a retrospective single-center study



Zhonghua Wai Ke Za Zhi 57(2): 102-107



目的: 比较机器人与腹腔镜胰体尾切除术的短期临床结果及住院费用。 方法: 采用回顾性队列研究。收集2016年1月至2018年7月福建医科大学附属协和医院基本外科施行的158例微创胰体尾切除术患者的临床资料。使用倾向评分匹配(PSM)方法对机器人胰体尾切除术组(RDP组)和腹腔镜胰体尾切除术组(LDP组)患者进行1∶1匹配。主要观察指标:手术时间、术中出血量、保脾情况、术后住院时间、并发症发生率、胰瘘发生率、住院费用等。计量资料的比较采用t检验或秩和检验,计数资料的比较采用χ(2)检验或Fisher确切概率法。 结果: 经PSM方法匹配后RDP组和RDP组各41例患者。RDP组中男性14例,女性27例,年龄(45.2±16.4)岁;LDP组中男性15例,女性26例,年龄(47.4±14.9)岁。RDP组手术时间为(209.7±52.9)min,LDP组为(186.5±56.7)min,两组差异无统计学意义(P=0.073)。RDP组中位术中出血量[50(15~175)ml]少于LDP组[100(50~350)ml](Z=-2.689,P=0.007)。两组非恶性病例均为38例,RDP组保脾率为76.3%(29/38),高于LDP组的44.7%(17/38)(χ(2)=7.930,P=0.005)。RDP组(9.4 d)和LDP组(10.6 d)术后住院时间的差异无统计学意义(P=0.372)。两组患者术后并发症发生率(RDP组12.2%,LDP组14.6%,P=0.746)和胰瘘发生率(RDP组7.3%,LDP组9.8%,P=1.000)的差异亦无统计学意义。RDP组的住院费用[(80 563.7±10 641.8)元]较LDP组[(57 792.8±8 943.0)元]高(t=4.515,P<0.01)。 结论: RDP和LDP均安全可行,RDP虽然增加了住院费用,但术中出血量更少、保脾率更高,对于希望保留脾脏的胰体尾非恶性肿瘤患者宜选择RDP。.

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