机器人经口腔前庭入路与传统开放性甲状腺癌根治手术的对比研究

A comparative study of robot-assisted transoral-vestibular thyroidectomy and conventional open thyroidectomy

摘要:

目的 比较达芬奇机器人辅助下经口腔前庭入路甲状腺癌根治手术（机器人组）与传统经颈部开放甲状腺癌根治手术（传统组）临床效果及卫生经济学。方法 回顾性分析2017年12月至2021年4月陆军军医大学大坪医院乳腺甲状腺外科收治的分别经机器人和传统手术治疗的62例单侧甲状腺癌根治手术患者的临床资料，观察分析2组手术时间、是否放置引流管、术后总引流量、引流管放置时间、疼痛评分、住院时间及住院费用等指标。结果 机器人组手术时间明显长于传统组，而在是否放置引流管、术后总引流量、引流管留置时间和住院时间方面明显优于传统组，差异有统计学意义（均P<0.01）；但在住院费用方面，机器人组明显高于传统组（P<0.001）。结论 机器人辅助下经口腔前庭入路甲状腺癌根治手术在术后患者住院管理和住院时间方面优于传统开放手术，术后美容效果好，值得推广应用。

Abstract:

Objective To compare the clinical effect and health economics between the Da Vinci robot-assisted transoral-vestibular thyroidectomy（robot group） and conventional open thyroidectomy（conventional group）.Methods The clinical data of 62 patients undergoing unilateral thyroidectomy by the robot-assisted method or conventional surgery in the Department of Breast and Thyroid Surgery，Daping Hospital of Army Medical University，from December 2017 to April 2021 were retrospectively analyzed. The operative time，drainage tube placement，total postoperative drainage volume，drainage tube placement time，pain score，length of hospital stay，and hospitalization expenses were observed and analyzed.Results The operative time of the robot group was significantly longer than that of the conventional group，while the drainage tube placement，total postoperative drainage volume，drainage tube placement time，and length of hospital stay of the robot group were significantly better than those of the conventional group（all P<0.01）. However，the hospitalization expenses were significantly higher in the robot group than in the conventional group（P<0.001）.Conclusion The Da Vinci robot-assisted transoral-vestibular thyroidectomy is superior to conventional open thyroidectomy in postoperative hospital management and length of hospital stay，with good postoperative cosmetic effect，which is worthy of promotion and application.