Objective: To compare the accuracy and effectiveness of orthopaedic robot-assisted minimally invasive surgery versus open surgery for limb osteoid osteoma.
Methods: A clinical data of 36 patients with limb osteoid osteomas admitted between June 2016 and June 2023 was retrospectively analyzed. Among them, 16 patients underwent orthopaedic robot-assisted minimally invasive surgery (robot-assisted surgery group), and 20 patients underwent tumor resection after lotcated by C-arm X-ray fluoroscopy (open surgery group). There was no significant difference between the two groups in the gender, age, lesion site, tumor nidus diameter, and preoperative pain visual analogue scale (VAS) scores ( P>0.05). The operation time, lesion resection time, intraoperative blood loss, intraoperative fluoroscopy frequency, lesion resection accuracy, and postoperative analgesic use frequency were recorded and compared between the two groups. The VAS scores for pain severity were compared preoperatively and at 3 days and 3 months postoperatively.
Results: Compared with the open surgery group, the robot-assisted surgery group had a longer operation time, less intraoperative blood loss, less fluoroscopy frequency, less postoperative analgesic use frequency, and higher lesion resection accuracy ( P<0.05). There was no significant difference in lesion resection time ( P>0.05). All patients were followed up after surgery, with a follow-up period of 3-24 months (median, 12 months) in the two groups. No postoperative complication such as wound infection or fracture occurred in either group during follow-up. No tumor recurrence was observed during follow-up. The VAS scores significantly improved in both groups at 3 days and 3 months after surgery when compared with preoperative value ( P<0.05). The VAS score at 3 days after surgery was significantly lower in robot-assisted surgery group than that in open surgery group ( P<0.05). However, there was no significant difference in VAS scores at 3 months between the two groups ( P>0.05).
Conclusion: Compared with open surgery, robot-assisted resection of limb osteoid osteomas has longer operation time, but the accuracy of lesion resection improve, intraoperative blood loss reduce, and early postoperative pain is lighter. It has the advantages of precision and minimally invasive surgery.
目的: 比较骨科机器人辅助微创手术与开放手术切除肢体骨样骨瘤的准确性与疗效。.
方法: 回顾分析2016年6月—2023年6月收治的36例肢体骨样骨瘤患者临床资料，其中16例选择骨科机器人辅助微创切除瘤巢手术（机器人手术组），20例采用常规C臂X线机透视定位后切除肿瘤（开放手术组）。两组患者性别、年龄、病灶部位、瘤巢直径以及术前疼痛视觉模拟评分（VAS）等基线资料比较，差异均无统计学意义（ P>0.05）。记录并比较两组手术时间、病灶切除时间、术中出血量、术中透视次数、病灶切除准确度、术后止痛药使用次数，以及术前及术后3 d、3个月疼痛程度（VAS评分）。.
结果: 与开放手术组相比，机器人手术组手术时间延长，但术中出血量、透视次数及术后止痛药使用次数均减少，病灶切除准确度提高，差异均有统计学意义（ P<0.05）；病灶切除时间差异无统计学意义（ P>0.05）。两组患者术后均获随访，随访时间均为3～24个月，中位时间均为12个月。术后两组均无切口感染、骨折等并发症发生。随访期间均无肿瘤复发。两组患者术后3 d、3个月时VAS 评分均较术前改善（ P<0.05）；术后3 d机器人手术组VAS评分较开放手术组更低（ P<0.05），但术后3个月VAS评分组间差异无统计学意义（ P>0.05）。.
结论: 与开放手术相比，骨科机器人辅助下切除肢体骨样骨瘤虽然手术时间延长，但病灶切除准确度提高、术中出血量减少、术后早期疼痛程度更轻，具有精准、微创优势。.
Keywords: Osteoid osteoma; early effectiveness; minimally invasive surgery; orthopaedic robot.