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目的:比较达芬奇机器人手术系统行扩大的胰体尾导管腺癌淋巴结清扫术与标准的淋巴结清扫术的临床疗效。方法:回顾性分析我院外科自2010年4月至2015年9月收治54例胰体尾导管腺癌病人的临床资料,其中37例行标准的淋巴结清扫术,17例行扩大的淋巴结清扫术。比较两组病人一般资料、手术时间、术中出血量、术后住院天数、淋巴结清扫数、术后并发症发生率。结果:扩大清扫组与标准清扫组病人一般情况基本一致。扩大清扫组手术时间长于标准清扫组,有统计学差异(231.5 min比141.4 min,P<0.001)。扩大清扫组术后住院天数长于标准清扫组,有统计学差异(22.8 d比20.4 d,P<0.05)。扩大清扫组淋巴结清扫个数多于标准清扫组,有统计学差异(11.2枚比6.1枚,P<0.001)。两组术中出血量、胰漏、胃排空障碍、术后出血、术后感染发生率差异均无统计学意义(P>0.05)。结论:机器人手术系统行胰体尾导管腺癌的淋巴结扩大清扫是安全的,与标准清扫无统计学差异,不增加病人的并发症发生率。
OBJECTIVE: To compare the clinical efficacy of Da Vinci robotic surgery with extended pancreatic ductal adenocarcinoma lymphadenectomy and standard lymphadenectomy. Methods: The clinical data of 54 patients with pancreatic ductal adenocarcinoma admitted to our department from April 2010 to September 2015 were retrospectively analyzed. Among them, 37 patients underwent standard lymph node dissection and 17 patients underwent expanded lymph node dissection . The general information, operation time, intraoperative blood loss, postoperative hospital stay, lymph node dissection and postoperative complication rates were compared between the two groups. Results: The general situation of patients in the extended cleaning group and the standard cleaning group was basically the same. There was a statistically significant difference between the two groups (231.5 min vs 141.4 min, P <0.001). There was a statistically significant difference between the two groups (> 22.8 days vs. 20.4 days, P <0.05). There was a statistically significant difference in the number of lymphadenectasia between the two groups (11.2 vs 6.1, P <0.001). There was no significant difference between the two groups in the amount of blood loss, pancreatic leakage, gastric emptying, postoperative bleeding, postoperative infection rate (P> 0.05). Conclusion: It is safe to expand and clean the lymph nodes of the pancreatic duct tail body ductal adenocarcinoma in robotic surgery system. There is no statistical difference between the two methods. The incidence of complication is not increased.