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中华结直肠疾病电子杂志 ›› 2018, Vol. 07 ›› Issue (04) : 332 -336. doi: 10.3877/cma.j.issn.2095-3224.2018.04.005

所属专题: 机器人手术 经自然腔道取标本手术学 文献

论著

机器人腹部无切口直肠癌前切除术
牛正川1, 韦烨1,(), 朱德祥1, 许剑民1,()   
  1. 1. 200032 上海,复旦大学附属中山医院普外科
  • 收稿日期:2018-06-20 出版日期:2018-08-25
  • 通信作者: 韦烨, 许剑民
  • 基金资助:
    上海结直肠肿瘤微创工程技术研究中心(No.17D2252600)

Robotic anterior resection of rectal cancer without abdominal incision

Zhengchuan Niu1, Ye Wei1,(), Dexiang Zhu1, Jianmin Xu1,()   

  1. 1. Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China
  • Received:2018-06-20 Published:2018-08-25
  • Corresponding author: Ye Wei, Jianmin Xu
  • About author:
    Corresponding author: Wei Ye, Email:
    Xu Jianmin, Email:
引用本文:

牛正川, 韦烨, 朱德祥, 许剑民. 机器人腹部无切口直肠癌前切除术[J]. 中华结直肠疾病电子杂志, 2018, 07(04): 332-336.

Zhengchuan Niu, Ye Wei, Dexiang Zhu, Jianmin Xu. Robotic anterior resection of rectal cancer without abdominal incision[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2018, 07(04): 332-336.

目的

经自然腔道取标本手术(NOSES)可避免腹部切口,具有美观、术后恢复快的优势。本中心采用NOSES术式,创新性地开展了机器人无切口直肠癌前切除术。

方法

本研究纳入2013年10月至2015年12月期间共19例早期完成该手术的患者,分析其临床病理特征,围手术期相关结果及术后随访资料。

结果

所有手术均成功实施,术后恢复良好,均顺利出院。随访期间,未发生严重腹、盆腔感染;无明显排尿困难、性功能障碍和排便失禁;肿瘤学结果较好。

结论

结果证实,机器人腹部无切口直肠癌前切除术安全、可行,但其远期结果评估需增加样本量,并行进一步随访。

Objective

Natural orifice specimen extraction surgery (NOSES) can avoid additional abdominal incisions, improve cosmetic outcomes and have quick postoperative recovery. In our center, robotic anterior resection of rectal cancer without additional abdominal incision was performed innovatively using NOSES approach.

Methods

During October 2013 to December 2015, totally 19 patients undergoing this surgery were included into presented retrospective study. Patients′ clinicopathological characteristics, perioperative related outcomes, and follow-up outcomes were recorded.

Results

All operations were carried out successfully. Patients recovered well after operation and discharged uneventfully. During the follow-up period, there is no serious abdominal and pelvic infections. No dysuria, sexual function disorder and fecal incontinence were found, and oncological outcomes were acceptable.

Conclusion

Taken together, robotic anterior resection of rectal cancer without abdominal incision is safe and feasible. Still, its long-term outcomes require increasing sample size and further investigation.

图1 机器人NOSES经直肠外翻切除、标本取出。1A通过肠壁切口将底砧座放入近端肠腔;1B经肛门直肠外翻;1C直视下切除标本;1D残端推回腹腔内行端端吻合术
表1 患者基线指标
表2 围手术期指标
表3 术后并发症
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