切换至 "中华医学电子期刊资源库"

中华结直肠疾病电子杂志 ›› 2020, Vol. 09 ›› Issue (02) : 122 -126. doi: 10.3877/cma.j.issn.2095-3224.2020.02.003

所属专题: 机器人手术 文献

专家论坛

达芬奇机器人手术系统在直肠癌侧方淋巴结清扫中的应用进展
池诏丞1, 程龙伟1,(), 姜晶1   
  1. 1. 130012 长春,吉林省肿瘤医院结直肠胃腹部肿瘤外二科
  • 收稿日期:2020-02-01 出版日期:2020-04-25
  • 通信作者: 程龙伟
  • 基金资助:
    吉林省卫生与健康技术创新项目(No.2018J024)

Application progress of DaVinci robotic surgical system in lateral lymph node dissection of rectal cancer

Zhaocheng Chi1, Longwei Cheng1,(), Jing Jiang1   

  1. 1. Department-2 of Colorectal and Gastroenterology, Jilin Cancer Hospital, Changchun 130012, China
  • Received:2020-02-01 Published:2020-04-25
  • Corresponding author: Longwei Cheng
  • About author:
    Corresponding author: Cheng Longwei, Email:
引用本文:

池诏丞, 程龙伟, 姜晶. 达芬奇机器人手术系统在直肠癌侧方淋巴结清扫中的应用进展[J/OL]. 中华结直肠疾病电子杂志, 2020, 09(02): 122-126.

Zhaocheng Chi, Longwei Cheng, Jing Jiang. Application progress of DaVinci robotic surgical system in lateral lymph node dissection of rectal cancer[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(02): 122-126.

达芬奇机器人手术系统具有三维高清图像和操作稳定灵活的优势,已广泛应用于直肠癌手术,并成为侧方淋巴结清扫的新方法。本文在介绍机器人手术系统特点的同时,结合本中心的经验对机器人侧方淋巴结清扫的应用现状进行回顾,并对其关键技术进行介绍。目前,机器人侧方淋巴结手术的安全性和有效性已得到肯定,与腹腔镜及开腹手术相比具有潜在优势。相信随着手术设备的进步和高质量临床研究的开展,机器人手术系统将在直肠癌侧方淋巴结清扫手术中发挥更重要的作用。

The DaVinci robotic surgical system has the advantages of three-dimensional high-definition images and stable and flexible operation. It has become a new method for lateral lymph node dissection on the basis of wide application in rectal cancer surgery. This article introduces the characteristics of the robotic surgical system, and reviews the current status of the application of robotic lateral lymph node dissection in combination with the experience of our center, and introduces its key techniques. At present, the safety and effectiveness of robotic lateral lymph node dissection have been affirmed, which has potential advantages over laparoscopic and open surgery. It is believed that with the advancement of surgical equipment and the development of high-quality research, robotic surgical system will play a more important role in lateral lymph node dissection of rectal cancer.

图1 达芬奇机器人直肠癌侧方淋巴清扫Trocar位置模式图
图2 达芬奇机器人直肠癌侧方淋巴清扫Trocar位置
图3 侧方淋巴结清扫的内侧界
图4 侧方淋巴结清扫的外侧界
图5 侧方淋巴结清扫效果图
[1]
董新舒, 都凤昌, 赵家宏, 等.直肠癌淋巴结转移的临床病理学研究(初步报告) [J].哈尔滨医科大学学报, 1983, 3: 61-65.
[2]
董新舒, 崔滨滨, 王锡山, 等.侧方淋巴转移及其清扫在直肠癌治疗中的意义[J]. 腹部外科, 2000, 13(2): 70-71.
[3]
中国医师协会内镜医师分会腹腔镜外科专业委员会, 中国医师协会结直肠肿瘤专业委员会腹腔镜专业委员会, 中华医学会外科学分会结直肠外科学组. 中国直肠癌侧方淋巴结转移诊疗专家共识(2019版) [J]. 中华胃肠外科杂志, 2019, 22(10): 901-912.
[4]
Weber PA, Merola S, Wasielewski A,et al. Telerobotic assisted laparoscopic right and sigmoid colectomies for benign disease [J]. Dis Colon Rectum, 2002, 45(12): 1689-1696.
[5]
Pigazzi A, Ellenhorn JD, Ballantyne GH, et al. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer [J]. Surg Endosc, 2006, 20(10): 1521-1525.
[6]
杜晓辉, 沈笛, 夏绍友, 等. 应用达芬奇机器人手术系统治疗低位直肠癌[J]. 中华消化外科杂志, 2010, 9(2): 116-118.
[7]
Marescaux J, Leroy J, Gagner M, et al. Transatlantic robot-assisted telesurgery [J]. Nature, 2001, 413(6854): 379-380.
[8]
许平平, 许剑民. 机器人手术系统在直肠癌手术中应用现状[J/CD]. 中华结直肠疾病电子杂志, 2017, 6(6): 454-457.
[9]
官国先, 池畔.直肠癌侧方淋巴结清扫争议与共识[J]. 中国实用外科杂志, 2018, 38(10): 1114-1118.
[10]
Christou N, Meyer J, Toso C, et al. Lateral lymph node dissection for low rectal cancer: Is it necessary? [J]. World J Gastroenterol, 2019, 25(31): 4294-4299.
[11]
杨盈赤, 杨鋆, 张忠涛. 直肠癌侧方淋巴结清扫的个性化治疗策略[J]. 中华外科杂志, 2020, 58(1): 52-56.
[12]
Ito M, Kobayashi A, Fujita S, et al. Urinary dysfunction after rectal cancer surgery: Results from a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for clinical stage II or III lower rectal cancer (Japan Clinical Oncology Group Study, JCOG0212) [J]. Surg Oncol, 2018, 44(4): 463-468.
[13]
Saito S, Fujita S, Mizusawa J, et al. Male sexual dysfunction after rectal cancer surgery: Results of a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for patients with lower rectal cancer: Japan Clinical Oncology Group Study JCOG0212 [J]. Eur J Surg Oncol, 2016, 42(12): 1851-1858.
[14]
Uyama I, Sugioka A, Matsui H, et al. Laparoscopic lateral node dis- section with autonomic nerve preservation for advanced lower rectal cancer [J]. J Am Coll Surg, 2001, 193(5): 579-584.
[15]
Yamaguchi T, Konishi T, Kinugasa Y, et al. Laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer:A subgroup analysis of a large multicenter cohort study in Japan [J]. Dis Colon Rectum, 2017, 60(9): 954-964.
[16]
Takahashi T, Ueno M, Azekura K, et al. Lateral node dissection and total mesorectal excision for rectal cancer [J]. Dis Colon Rectum, 2000, 43(10): s59-s68.
[17]
池畔, 官国先. 腔镜直肠癌根治术侧方淋巴结清扫的关键技术与意义[J/CD]. 中华普外科手术学杂志(电子版), 2019, 13(1): 5-7.
[18]
孟文建, 王自强, 周总光. 低位直肠癌新辅助放化疗后腹腔镜侧方淋巴结清扫术(附视频) [J/CD]. 中华结直肠疾病电子杂志, 2018, 7(3): 298-300.
[19]
练磊, 谢明颢.从"两面三道"浅谈直肠癌手术侧方淋巴结清扫的技巧[J]. 中华胃肠外科杂志, 2019, 22(6): 597-600.
[20]
Ju-A Park, Gyu-Seog Choi, Jun Seok Park, et al. Initial clinical experience with robotic lateral pelvic lymph node dissection for advanced rectal cancer [J]. J Korean Soc Coloproctol, 2012, 28(5): 265-270.
[21]
Kagawa H, Kinugasa Y, Shiomi A, et al. Robotic-assisted lateral lymph node dissection for lower rectal cancer: short-term outcomes in 50 consecutive patients [J]. Surg Endosc, 2015, 29(4): 995-1000.
[22]
Yamaguchi T, Kinugasa Y, Shiomi A, et al. Robotic-assisted laparoscopic versus open lateral lymph node dissection for advanced lower rectal cancer [J]. Surg Endosc, 2016, 30(2): 721-728.
[23]
Yamaguchi T, Kinugasa Y, Shiomi A, et al. Oncological outcomes of robotic-assisted laparoscopic versus open lateral lymph node dissection for locally advanced low rectal cancer [J]. Surg Endosc, 2018, 32(11): 4498-4505.
[24]
Kim HJ, Choi GS, Park JS, et al. Selective lateral pelvic lymph node dissection: a comparative study of the robotic versus laparoscopic approach [J]. Surg Endosc, 2018, 32(5): 2466-2473.
[25]
Kawai K, Hata K, Tanaka T, et al. Learning curve of robotic rectal surgery with lateral lymph node dissection: cumulative sum and multiple regression analyses [J]. J Surg Educ, 2018, 75(6): 1598-1605.
[26]
Kim HJ, Park JS, Choi GS, et al. Fluorescence-guided robotic total mesorectal excision with lateral pelvic lymph node dissection in locally advanced rectal cancer: a video presentation [J]. Dis Colon Rectum, 2017, 60(12): 1332-1333.
[27]
中国医师协会外科医师分会结直肠外科医师委员会, 中国研究型医院学会机器人与腹腔镜外科专业委员会. 机器人结直肠癌手术专家共识(2015) [J/CD].中华结直肠疾病电子杂志, 2015, 4(6): 584-590.
[28]
刘骞, 王锡山. 筋膜导向在低位直肠癌侧方淋巴结清扫中的应用价值[J]. 中华胃肠外科杂志, 2019, 22(5): 432-435.
[1] 燕速, 霍博文. 腹腔镜食管胃结合部腺癌根治性切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 13-13.
[2] 母德安, 李凯, 张志远, 张伟. 超微创器械辅助单孔腹腔镜下脾部分切除术[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 14-14.
[3] 李国新, 陈新华. 全腹腔镜下全胃切除术食管空肠吻合的临床研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 1-4.
[4] 李子禹, 卢信星, 李双喜, 陕飞. 食管胃结合部腺癌腹腔镜手术重建方式的选择[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 5-8.
[5] 李乐平, 张荣华, 商亮. 腹腔镜食管胃结合部腺癌根治淋巴结清扫策略[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 9-12.
[6] 陈方鹏, 杨大伟, 金从稳. 腹腔镜近端胃癌切除术联合改良食管胃吻合术重建His角对术后反流性食管炎的效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 15-18.
[7] 许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[8] 李刘庆, 陈小翔, 吕成余. 全腹腔镜与腹腔镜辅助远端胃癌根治术治疗进展期胃癌的近中期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 23-26.
[9] 任佳, 马胜辉, 王馨, 石秀霞, 蔡淑云. 腹腔镜全胃切除、间置空肠代胃术的临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 31-34.
[10] 王庆亮, 党兮, 师凯, 刘波. 腹腔镜联合胆道子镜经胆囊管胆总管探查取石术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 313-313.
[11] 杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[12] 叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.
[13] 郭兵, 王万里, 何凯, 黄汉生. 腹腔镜下肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 143-143.
[14] 李凯, 陈淋, 苏怀东, 向涵, 张伟. 超微创器械在改良单孔腹腔镜巨大肝囊肿开窗引流及胆囊切除中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 144-144.
[15] 魏丽霞, 张安澜, 周宝勇, 李明. 腹腔镜下Ⅲb型肝门部胆管癌根治术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(01): 145-145.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?