达芬奇机器人在超低位直肠癌保肛手术中的应用

doi:10.3877/cma.j.issn.2095-3224.2015.03.10

中华结直肠疾病电子杂志 ›› 2015, Vol. 04 ›› Issue (03) : 272 -274. doi: 10.3877/cma.j.issn.2095-3224.2015.03.10

所属专题：机器人手术；文献；

论著

达芬奇机器人在超低位直肠癌保肛手术中的应用

曾冬竹¹, 张超¹, 唐波¹, 甘露¹, 陈华¹, 雷晓¹, 罗华星¹, 兰远志¹, 余佩武¹^,^†(

)

^1. 400038　重庆，第三军医大学西南医院全军普通外科中心　微创胃肠外科中心

收稿日期:2015-04-23 出版日期:2015-06-25
通信作者: 余佩武

The application of Da Vinci robotic surgical system in anus preserving operation of ultra low rectal cancers

Dong-zhu ZENG¹, Chao ZHANG¹, Bo TANG¹, Lu GAN¹, Hua CHEN¹, Xiao LEI¹, Hua-xing LUO¹, Yuan-zhi LAN¹, Pei-wu YU¹^,^†()

^1. Department of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery Southwest Hospital, PLA General Surgery Center, The Third Military Medical University

Received:2015-04-23 Published:2015-06-25
Corresponding author: Pei-wu YU
About author:
Corresponding author: YU Pei-wu, Email: yupeiwu01@vip.sina.com

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目的

探讨达芬奇机器人手术系统在超低位直肠癌保肛手术中的作用。

方法

回顾分析第三军医大学西南医院于2010年3月至2014年6月应用达芬奇机器人手术系统完成52例超低位直肠癌前切除手术患者的临床资料。对患者的一般资料、手术情况、并发症的发生、术后恢复及病理性资料进行分析评估。

结果

52例患者均顺利完成前切除保肛手术，无中转开腹；手术时间193.7±43.2 min，术中出血量65.5±29.3 ml。淋巴结清扫18.2±5.6枚。远切缘距肿瘤2.4±0.2 cm、无癌细胞残留。术后并发症发生率为13.5%(7/52)，其中吻合口瘘5例、肺部感染1例，尿潴留1例，无死亡病例。

结论

达芬奇机器人手术系统在超低位直肠癌的前切除保肛手术中操作简便安全、创伤小、术后恢复快。

关键词: 直肠肿瘤, 外科手术, 治疗应用, 达芬奇机器人

Objective

To explore the application of Da Vinci robotic surgical system in anus preserving operation of ultra low rectal cancers.

Methods

Systematically review the 52 patients who underwent the ultra low APR with the Da Vinci robotic surgical system.The general situation, operations, complications, recovery and pathological feature were analyzed.

Results

All the 52 patients went through the operation successfully with no conversion, and their anus were preserved.The average operation time was 193.7±43.2 mins.The blood loss wsa 65.5±29.3 ml.The average number of harvested lymph nodes was 18.2±5.6.The average distance to tumor is 2.4±0.2cm without cancer cell residuing.The post operation complication ratio is 13.5%(7 in 52), in which 5 cases developed anomostosis leakage, 1 case pulmonary infection and 1 case urine retention.

Conclusion

The Da Vinci robotic surgical system in anus preserving operation of ultra low rectal cancers is convenient, safe, with fast recover and small trauma.

Key words: Rectal neoplasms, Surgical procedures, operative, Therapeutic uses, Da vinci robotic sugical system

表1 患者手术及术后情况表

组别		具体数据
手术时间(min)		193.7±43.2
术中出血量(ml)		65.5±29.3
第一次排气时间(d)		2.8±0.7
总并发症发生率[例(%)]		7(13.5)
吻合口瘘		5
?	肺部感染	1
?	尿储留	1
病理学资料		?
?	肿瘤远切缘(cm)	2.4±0.2
?	淋巴结清扫数目(枚)	18.2±5.6
TNM分期[例(%)]		?
?	Ⅰ期	16(30.8)
?	Ⅱ期	15(28.8)
?	Ⅲ期	21(40.4)

表1 患者手术及术后情况表

组别		具体数据
手术时间(min)		193.7±43.2
术中出血量(ml)		65.5±29.3
第一次排气时间(d)		2.8±0.7
总并发症发生率[例(%)]		7(13.5)
吻合口瘘		5
?	肺部感染	1
?	尿储留	1
病理学资料		?
?	肿瘤远切缘(cm)	2.4±0.2
?	淋巴结清扫数目(枚)	18.2±5.6
TNM分期[例(%)]		?
?	Ⅰ期	16(30.8)
?	Ⅱ期	15(28.8)
?	Ⅲ期	21(40.4)

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