文章摘要
张统一,朱荔勇,唐健雄,何嘉琦,蔡健华.达芬奇机器人与腹腔镜手术治疗胰腺癌的近期疗效比较及对血清CRP、PCT及肿瘤标志物的影响[J].,2022,(9):1651-1655
达芬奇机器人与腹腔镜手术治疗胰腺癌的近期疗效比较及对血清CRP、PCT及肿瘤标志物的影响
Comparison of Short-term Efficacy between da Vinci Robot and Laparoscopic Surgery in the Treatment of Pancreatic Cancer and its Effect on Serum CRP, PCT and Tumor Markers
投稿时间:2022-01-15  修订日期:2022-02-11
DOI:10.13241/j.cnki.pmb.2022.09.010
中文关键词: 达芬奇机器人  腹腔镜手术  胰腺癌  C-反应蛋白  降钙素原  糖类抗原19-9  糖类抗原125
英文关键词: Da Vinci robot  Laparoscopic surgery  Pancreatic cancer  C-reactive protein  Procalcitonin  Carbohydrate antigen 19-9  Saccharide antigen 125
基金项目:上海市科学技术委员会科研计划项目(19DZ1930801)
作者单位E-mail
张统一 复旦大学附属华东医院普外科 上海 200040 zhangtongyi2009@163.com 
朱荔勇 复旦大学附属华东医院普外科 上海 200040  
唐健雄 复旦大学附属华东医院普外科 上海 200040  
何嘉琦 复旦大学附属华东医院普外科 上海 200040  
蔡健华 复旦大学附属华东医院普外科 上海 200040  
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中文摘要:
      摘要 目的:探讨达芬奇机器人与腹腔镜手术治疗胰腺癌的近期疗效比较及对血清C-反应蛋白(CRP)、降钙素原(PCT)及肿瘤标志物的影响。方法:选择2019年1月至2020年1月在我院接受治疗的61例胰腺癌患者,根据手术方法分为机器人组(n=26)和腹腔镜组(n=35)。腹腔镜组给予腹腔镜手术治疗,机器人组给予达芬奇机器人辅助治疗。比较两组围术期情况、CRP 、PCT、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、术后恢复情况及并发症发生情况。结果:机器人组禁食时间及排气时间显著低于腹腔镜组,差异显著(P<0.05);治疗前,两组血清CA19-9、CA125水平无明显差异;治疗后,两组血清CA19-9、CA125水平治疗后较治疗前均显著下降差异显著(P<0.05);两组治疗后血清CA19-9、CA125水平比较无显著差异(P>0.05);治疗前,两组CRP、PCT水平无明显差异;治疗后,两组CRP、PCT明显升高,且机器人组低于腹腔镜组差异显著(P<0.05);机器人组和腹腔镜组术后下床活动时间、拔尿管时间、术后住院时间比较无显著差异;机器人组术后重症监护时间显著低于腹腔镜组,差异显著(P<0.05);两组患者治疗期间并发症总发生率分别为4.44%、6.67%,无显著差异(P>0.05)。结论:达芬奇机器人辅助能够显著提高胰腺癌手术质量,且对血清CRP 、PCT的影响较小,且对肿瘤标志物的影响与腹腔镜手术较为接近,为患者提供机器人微创治疗是未来临床的必然发展趋势。
英文摘要:
      ABSTRACT Objective: To studyComparison of short-term efficacy between da Vinci robot and laparoscopic surgery in the treatment of pancreatic cancer and its effect on serum C-reactive protein (CRP), procalcitonin (PCT) and tumor markers. Methods: 61 patients with pancreatic cancer who received treatment in our hospital from January 2019 to January 2020 were selected and divided into robotic group (n=26) and laparoscopic group (n=35) according to surgical methods. Laparoscopic surgery was given to the laparoscopic group, while Da Vinci robot assisted therapy was given to the robotic group. The perioperative conditions, CRP, PCT, carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 125 (CA125), postoperative recovery and complications were compared between the two groups. Results: The fasting time and exhaust time in the robot group were significantly lower than those in the laparoscopic group, the differences were significant(P<0.05). Before treatment, there was no significant difference in serum CA19-9 and CA125 levels between the two groups. After treatment, serum CA19-9 and CA125 levels in both groups were significantly decreased after treatment compared with before treatment(P<0.05). There were no significant differences in serum CA19-9 and CA125 levels between the two groups after treatment (P>0.05). Before treatment, there was no significant difference in CRP and PCT levels between the two groups. After treatment, CRP and PCT were significantly increased in the two groups, and the difference in the robot group was significantly lower than that in the laparoscopic group(P<0.05). There were no significant differences between the robot group and the laparoscopic group in the postoperative time of getting out of bed, catheter extraction time and postoperative hospitalization time. The duration of postoperative intensive care in the robot group was significantly shorter than that in the laparoscopic group(P<0.05). The total incidence of complications in 2 groups during treatment was 4.44% and 6.67%, respectively, with no significant difference(P>0.05). Conclusion: Da Vinci robot assisted can significantly improve the surgical quality of pancreatic cancer, and has little effect on serum CRP and PCT, and its effect on tumor markers is close to that of laparoscopic surgery. Therefore, it is an inevitable clinical development trend to provide minimally invasive robotic treatment for patients in the future.
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