评估机器人结直肠癌根治术不同阶段的手术效果，探讨机器人结直肠癌根治术学习曲线问题。

分析2014年12月至2015年8月由同一组医师完成的75例腹腔镜结直肠癌根治术，按手术先后次序分3组（A、B、C），每组25例，比较各组机器人安装时间、手术时间、出血量、肛门排气时间、术后住院天数、术后并发症和3站淋巴结清扫数目及其总数的差异。

A组机器人安装时间（38±5）min，显著长于B组（22±4）min和C组（21±2）min（P均<0.05）；A组手术时间（201±39）min，显著长于B组（160±42）min和C组（156±43）min（P均<0.05）；A组出血量（142±35）ml，显著多于B组（105±28）ml和C组（102±28）ml（P均<0.05）。3组肛门排气时间、术后住院天数、术后并发症和3站淋巴结清扫数目及其总数无显著性差异（P>0.05）。A组手术25例在4个月内完成，平均每月6.3台手术，B组和C组均在2个月内完成，平均每月12.5台手术。

有丰富腹腔镜结直肠癌手术经验的外科医师行机器人结直肠癌根治术的学习曲线大约为25例，手术频度为平均每月6.3例。

To evaluate the outcomes of robot-assisted laparoscopic radical colorectal resection and to define the learning curve of robot-assisted laparoscopic radical colorectal resections.

Clinical data of 75 cases underwent robot-assisted laparoscopic radical resection for colorectal cancer were reviewed form December 2014 to August 2015.The patients were divided into 3 groups (groups A, B and C) by operative sequence.The robotic set-up time, operating time, bleeding volume, postoperative aerofluxus time, hospital stay, postoperative complications, number of removed lymphatic nodes were compared among the 3 groups.

The robotic set-up time in group A was significantly longer than that in group B and C [ (38 ± 5) min vs. (22 ± 4) min, P<0.05; (38±5) min vs. (21±2) min, P<0. 05 ], and there was no significant difference between group B and group C (P>0.05). The operating time in group A was (201±39) min, significantly longer than that in group B (160±42) min and group C (156±43) min (P<0.05), but the operating time did not vary significantly between group B and C (P>0.05). The bleeding volume was significantly greater in group A than in group B and C (142±35, 105±28, and 102±28ml, respectively, P<0.05), but showed no significant difference between the latter two groups (P>0.05). No significant difference was found in post operative aerofluxus time, hospital stay, postoperative complications, number of removed lymphatic nodes among the 3 groups (P>0. 05). The 25 patients in group A received the operation within a time period of 4 months (6.3 cases per month), and groups B and C were done in 2 months (12.5 cases per month).

The surgeons with abundant experiences of laparoscopic colorectal cancer surgery can learn the surgical skills after performing 25 robot-assisted laparoscopic radical resections for colorectal neoplasms, the operation frequency was an average of 6.3 cases per month.