机器人辅助降低减肥术并发症

2012-07-31 刘揆亮译 医学论坛网

  2012年6月22日,在加利福尼亚州圣地亚哥召开的美国代谢和肥胖病外科学会(ASMBS)第29届年会上报告的一项新研究表明,机器人辅助的腹腔镜下胃旁路手术可能减少早期并发症和死亡。   来自德克萨斯、缅因和佛罗里达大型减肥中心的研究者报告称,在连续1,695例机器人辅助腹腔镜下胃旁路手术后,30天内没有出现死亡,主要并发症发生率为0.3%。手术在2003至2011年间进行,手术患者平均体重指

  2012年6月22日,在加利福尼亚州圣地亚哥召开的美国代谢和肥胖病外科学会(ASMBS)第29届年会上报告的一项新研究表明,机器人辅助的腹腔镜下胃旁路手术可能减少早期并发症和死亡。

  来自德克萨斯、缅因和佛罗里达大型减肥中心的研究者报告称,在连续1,695例机器人辅助腹腔镜下胃旁路手术后,30天内没有出现死亡,主要并发症发生率为0.3%。手术在2003至2011年间进行,手术患者平均体重指数(BMI)为≥48。

  研究首席作者、休斯顿德克萨斯大学医学中心(UT Health)及德克萨斯赫曼纪念医学中心的代谢和肥胖病外科医生、医学博士埃里克•威尔森,其所在中心进行了578例手术,他说:“机器人手术目前常用于前列腺及其它手术中,但在减肥手术中还没有应用。这项研究表明,我们能够应用机器人完成一项已经非常安全的手术,并可使其更为安全;并且,随着我们所见到的并发症减少,机器人手术可能更具价-效比。”

  研究发现,机器人辅助手术的30天死亡率(0)及严重并发症胃肠道漏或胃肠道脓肿(0.3%)的发生率均较传统腹腔镜手术降低,后者的30天死亡率为0.2%,主要并发症发生率3.6%。体重下降及病情改善方面的其它结果相似。威尔森医生说这项研究中所分析的近1,700例机器人辅助手术是迄今报道的规模最大的机器人减肥手术的病例研究。

  其它的30天结果包括81例再入院(4.8%)和46例二次手术(2.7%),原因包括肠梗阻(17)、感染(5)、出血(18)和阴性探查(6)。14例患者(0.8%)需要输血,4例患者(0.2%)诊为早期狭窄。平均住院日2.2天。

  机器人辅助胃旁路手术中,手术者坐在远离手术台的操作台旁,操纵控制两只机器臂进行手术。一只机器臂作为腹腔镜摄像机提供体内的三维图像,另一只机器臂发挥手术者自身手的作用,进行胃减容和消化道改道手术。

  “机器人使我们可在体内更窄小的空间内进行操作,并可使手术更为精确,这可能影响到并发症的发生”,威尔森医生补充道,“并发症的减少或避免可能会抵消对于机器人系统最初的投资。”

    

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    2013-01-05 丁鹏鹏
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    2012-11-17 kksonne
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    2012-08-02 xue8602
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