Safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index
Clinical research|更新时间:2025-12-29
|
Safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index
Journal of Chongqing Medical UniversityVol. 49, Issue 1, Pages: 70-74(2024)
Zhu Mengqiu,Yi Qianlin,Wu Jialin,et al.Safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index[J].Journal of Chongqing Medical University,2024,49(1):70-74.
Zhu Mengqiu,Yi Qianlin,Wu Jialin,et al.Safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index[J].Journal of Chongqing Medical University,2024,49(1):70-74. DOI: 10.13406/j.cnki.cyxb.003401.
Safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index
=725)患者的病例资料。按照不同等级体质指数(body mass index,BMI)对患者进行分层(非超重、超重和肥胖),比较2组中各BMI亚组间患者的围术期情况、术中及术后并发症。
结果
2
机器人组中超重亚组的手术时间短于传统腹腔镜组[(125.37±50.92) min vs. (135.68±44.55) min],机器人组中3个BMI亚组的术中出血量均少于传统腹腔镜组[(60.46±45.20) mL vs. (92.88±105.13) mL、(72.01±62.03) mL vs. (115.02±123.38) mL及(65.59±37.92) mL vs. (125.16±96.07) mL],机器人组中超重亚组和肥胖亚组的首次排气时间均短于传统腹腔镜组[(2.04±0.83) d vs. (2.19±0.63) d和(1.97±0.54) d vs. (2.19±0.54) d],差异均有统计学意义(
P
<
0.05)。机器人组中各BMI亚组术中及术后总体并发症发生率仍低于腹腔镜组,但差异无统计学意义(
P
>
0.05)。
结论
2
超重和肥胖患者的全子宫切除术,机器人辅助腹腔镜相较于传统腹腔镜在围术期降低并发症等方面有一定优势。
Abstract
Objective
2
To investigate the safety and feasibility of robot-assisted laparoscopic total hysterectomy versus traditional laparoscopic total hysterectomy in patients with different levels of body mass index.
Methods
2
A retrospective analysis was performed for the case data of 416 patients who received robot-assisted laparoscopic total hysterectomy and 725 patients who received traditional laparoscopic total hysterectomy in The First Affiliated Hospital of Chongqing Medical University from February 2016 to April 2021. The patients were stratified according to the different levels of body mass index(non-overweight,overweight,and obese),and the two groups and the subgroups based on body mass index were compared in terms of perioperative conditions and intraoperative and postoperative complications.
Results
2
The overweight subgroup in the robot-assisted laparoscopic group had a significantly shorter time of operation than that in the traditional laparoscopic group[(125.37±50.92) min vs. (135.68±44.55) min,
P
<
0.05],and all three subgroups in the robot-assisted laparoscopic group had significantly lower intraoperative blood loss than those in the traditional laparoscopic group[non-overweight:(60.46±45.20) mL vs. (92.88±105.13) mL,
P
<
0.05;overweight:(72.01±62.03) mL vs. (115.02±123.38) mL,
P
<
0.05; obese:(65.59±37.92) mL vs. (125.16±96.07) mL,
P
<
0.05]. The overweight and obese subgroups in the robot-assisted laparoscopic group had a significantly shorter time to first flatus than those in the traditional laparoscopic group[overweight:(2.04±0.83) d vs. (2.19±0.63) d,
P
<
0.05;obese:(1.97±0.54) vs. (2.19±0.54) d,
P
<
0.05]. All three subgroups in the robot-assisted laparoscopic group had a lower overall incidence rate of intraoperative a
nd postoperative complications than those in the traditional laparoscopic group,but with no statistical significance(
P
>
0.05).
Conclusion
2
As for total hysterectomy in overweight and obese patients,robot-assisted laparoscopy has certain advantages over traditional laparoscopy in reducing perioperative complications.
Li JT , Lu ET , Tian DL , et al . Influence of body mass index on robot-assisted laparoscopic hysterectomy [J ] . Chin J Rob Surg , 2022 , 3 ( 1 ): 42 - 47 .
Wang HB , Li LM , Hu XL , et al . Comparison of complications and risk assessment in obese women undergoing laparoscopic complete hysterectomy [J ] . Med Pharm J Chin People’s Liberation Army , 2019 , 31 ( 8 ): 66 - 69 .
Davidson BA , Weber JM , Monuzsko KA , et al . Evaluation of surgical morbidity after hysterectomy during an obesity epidemic [J ] . Obstet Gynecol , 2022 , 139 ( 4 ): 589 - 596 .
Krane MK , Allaix ME , Zoccali M , et al . Does morbid obesity change outcomes after laparoscopic surgery for inflammatory bowel disease?Review of 626 consecutive cases [J ] . J Am Coll Surg , 2013 , 216 ( 5 ): 986 - 996 .
Lagares-Garcia J , O'Connell A , Firilas A , et al . The influence of body mass index on clinical short-term outcomes in robotic colorectal surgery [J ] . Int J Med Robot , 2016 , 12 ( 4 ): 680 - 685 .
Huang NX , Xiao L , Ma D , et al . Comparison between robot-assisted radical hysterectomy and conventional laparoscopic radical hysterectomy [J ] . Chin J Rob Surg , 2020 , 1 ( 2 ): 77 - 85 .
Li JJ , Ouyang XP , Gong X , et al . Clinical comparison between traditional and robot-assisted laparoscopic radical hysterectomy in treatment of cervical cancer [J ] . Chin J Rob Surg , 2020 , 1 ( 3 ): 166 - 173 .
Brunes M , Johannesson U , Häbel H , et al . Effects of obesity on peri- and postoperative outcomes in patients undergoing robotic versus conventional hysterectomy [J ] . J Minim Invasive Gynecol , 2021 , 28 ( 2 ): 228 - 236 .
El-Achi V , Weishaupt J , Carter J , et al . Robotic versus laparoscopic hysterectomy in morbidly obese women for endometrial cancer [J ] . J Robot Surg , 2021 , 15 ( 3 ): 483 - 487 .
Kannisto P , Harter P , Heitz F , et al . Implementation of robot-assisted gynecologic surgery for patients with low and high BMI in a German gynecological cancer center [J ] . Arch Gynecol Obstet , 2014 , 290 ( 1 ): 143 - 148 .
Montané B , Toosi K , Velez-Cubian FO , et al . Effect of obesity on perioperative outcomes after robotic-assisted pulmonary lobectomy [J ] . Surg Innov , 2017 , 24 ( 2 ): 122 - 132 .
Koythong T , Thigpen B , Sunkara S , et al . Surgical outcomes of hysterectomy via robot-assisted versus traditional transvaginal natural orifice transluminal endoscopic surgery [J ] . J Minim Invasive Gynecol , 2021 , 28 ( 12 ): 2028 - 2035 .
Matsuo K , Mandelbaum RS , Nusbaum DJ , et al . Risk of upper-body adverse events in robot-assisted total laparoscopic hysterectomy for benign gynecologic disease [J ] . J Minim Invasive Gynecol , 2021 , 28 ( 9 ): 1585 - 1594 .
Haveman I , van Weelden WJ , Roovers EA , et al . Robot-assisted total laparoscopic hysterectomy in different classes of obesity:a cohort study [J ] . JSLS , 2022 , 26 ( 1 ): e2021 . 00077.
Gracia M , García-Santos J , Ramirez M , et al . Value of robotic surgery in endometrial cancer by body mass index [J ] . Int J Gynaecol Obstet , 2020 , 150 ( 3 ): 398 - 405 .