Remebot机器人辅助立体定向活检术诊断率的影响因素分析

Factors affecting the diagnostic yield of Remebot robot-assisted stereotactic biopsy

摘要:

目的 探讨Remebot机器人应用于颅内病变行立体定向活检手术中的安全性及有效性并分析影响其诊断率的因素。方法 2016年10月—2019年12月对武汉同济医院收治的89例患者颅内病变采用Remebot机器人辅助立体定向活检手术的临床资料进行回顾性分析，并对影响诊断率的相关因素进行单因素及多因素分析。结果 所有患者均顺利完成手术，有81例得到明确组织病理学诊断（诊断率为91%），5例出现术后并发症（并发症率5.6%）；单因素分析发现年龄≥40岁、病灶较大、病灶强化均可提高活检手术的诊断率（P均<0.05）。Logistic回归发现，仅病灶大小及病灶强化是影响诊断率的主要因素。结论 颅内深部成重要功能区病变患者采用Remebot机器人辅助立体定向活检术创伤小、诊断率高且并发症低，在临床中的应用价值明显并可进一步推广。病灶大小及病灶强化为影响活检诊断率的主要因素，手术时应予以重视。

Abstract:

Objective To explore the safety and effectiveness of Remebot robot-assisted stereotactic biopsy to the diagnosis of intracranial lesions, and provide an analysis of factors affecting the diagnostic yield. Methods A retrospective study was conducted of 89 patients undergoing Remebot robot-assisted stereotactic biopsy at our institution from Oct 2016 to Dec 2019. Diagnostic accuracy, surgical complications and clinical characteristics associated with non-diagnostic biopsy were evaluated. Results Biopsy was successfully performed in all patients and a definitive histologic diagnosis was established in 81 cases with a diagnostic yield of 91%. Postoperative complication occurred in 5 patients with a complication rate of 5.6%. Univariate analysis revealed that patient's age older than 40, the large tumor size and the enhancement of lesion appeared to increase the diagnostic accuracy (all P<0.05). The size and enhancement of lesion were suggested by Logistic regression analysis to have significant influence on the diagnostic accuracy. Conclusions With advantages of minimal invasion, high diagnostic yield and low complication rate, Remebot robot-assisted stereotactic biopsy is an important medical auxiliary technology in the patients with intracranial lesions and should be worthy of further promotion. Before biopsy, more attention should be paid to the tumor size and enhancement of the lesions which significantly influence the diagnostic yield.