对比分析达·芬奇机器人与腹腔镜食管裂孔疝修补术的临床疗效和近期生活质量。

纳入2016年3月至2021年1月，由西安交通大学第一附属医院胸外科连续所行微创食管裂孔疝修补术患者共70例资料进行回顾分析，依患者手术意愿分为机器人组23例，采用达·芬奇机器人食管裂孔疝修补术（RHH）治疗，腹腔镜组47例，采用腹腔镜食管裂孔疝修补术（LHH）治疗。对比分析两组临床特征及手术指标，术后主要并发症情况及近期生活质量。

两组临床特征比较，差异均无统计学意义（P>0.05）。两组手术时间、术中出血量比较，差异无统计学意义（P>0.05）。两组术后肺炎、心律失常、吞咽困难发生率差异无统计学意义（P>0.05）。术后平均住院时间机器人组为（3.4±1.6）d，低于腹腔镜组（5.7±1.9）d，差异有统计学意义（P<0.05）。两组患者90 d死亡率均为0。机器人组疝复发率为0，明显低于腹腔镜组的6.3%，差异有统计学意义（P<0.05）。近期生活质量：患者术后3、12个月，消化病生存质量指数（GIQLI）总评分均高于术前，差异有统计学意义（P<0.05）；但两组GIQLI评分比较差异无统计学意义（P>0.05）。

达·芬奇机器人食管裂孔疝修补术安全可行，与腹腔镜相比，在促进患者术后快速康复、降低疝复发率方面具有明显优势，对患者术后近期生活质量有显著改善。

To compare the clinical efficacy and short-term quality of life between the Da Vinci robotic and laparoscopic hiatal hernia repair surgeries.

A retrospective analysis of 70 patients who underwent minimally invasive hiatal hernia repair surgery consecutively performed by the Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, between March 2016 and January 2021 was conducted. Based on patient surgical preferences, 23 were assigned to the robot-assisted group, receiving Da Vinci robotic hiatal hernia repair (RHH), and 47 to the laparoscopic group, receiving laparoscopic hiatal hernia repair (LHH). Clinical characteristics, surgical indices, post-operative major complications, and short-term quality of life were compared between the two groups.

No significant difference in clinical characteristics was found between the two groups (P>0.05). Surgery duration and intraoperative blood loss were also comparable (P>0.05). There was no statistical difference in post-operative complications such as pneumonia, arrhythmia, and dysphagia (P>0.05). The average post-operative hospital stay for the robot-assisted group was (3.4±1.6) days, significantly shorter than the laparoscopic group's (5.7±1.9) days (P<0.05). The 90-day mortality rate for both groups was 0%. The hernia recurrence rate for the robotic group was 0%, significantly lower than the 6.3% in the laparoscopic group (P<0.05). In terms of short-term quality of life, Gastrointestinal Quality of Life Index (GIQLI) scores at 3 and 12 months post-operatively were significantly higher than pre-operation (P<0.05) for both groups, with no significant difference between the two groups' scores (P>0.05).

The Da Vinci robotic hiatal hernia repair surgery is safe and feasible. Compared to the laparoscopic method, it provides notable advantages in promoting faster post-operative recovery and reducing hernia recurrence rates, significantly improving patients' short-term quality of life.