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中华结直肠疾病电子杂志 ›› 2026, Vol. 15 ›› Issue (04) : 340 -348. doi: 10.3877/cma.j.issn.2095-3224.2026.04.007

论著

机器人单切口加一孔与腹腔镜多孔全结肠切除术治疗慢传输型便秘的短期疗效比较
杜修琪1, 侍新宇1, 胡优1, 王索2, 孙金兵2, 钟润泽1, 柯子昂1, 王梦婷1, 穆丽茜1, 张丽娟1, 周晓俊1, 何宋兵1,()   
  1. 1 215000 苏州大学附属第一医院普外科
    2 215006 苏州大学附属常熟医院普外科
  • 收稿日期:2026-04-18 出版日期:2026-08-25
  • 通信作者: 何宋兵
  • 基金资助:
    江苏省中医药科技发展项目(MS2025123); 苏州大学苏州医学院齐鲁医学科研基金项目(24QL200103); 常熟市D类“临床医学专家团队”引进项目(CSYJTD202101)

Short-term outcomes of robotic single-incision plus one port versus multiport laparoscopic total colectomy for slow transit constipation

Xiuqi Du1, Xinyu Shi1, You Hu1, Suo Wang2, Jinbing Sun2, Runze Zhong1, Ziang Ke1, Mengting Wang1, Liqian Mu1, Lijuan Zhang1, Xiaojun Zhou1, Songbing He1,()   

  1. 1 Department of General Surgery, the First Affiliated Hospital of Soochow University, Suzhou 215000, China
    2 Department of General Surgery, Changshu Hospital Affiliated to Soochow University, Suzhou 215006, China
  • Received:2026-04-18 Published:2026-08-25
  • Corresponding author: Songbing He
引用本文:

杜修琪, 侍新宇, 胡优, 王索, 孙金兵, 钟润泽, 柯子昂, 王梦婷, 穆丽茜, 张丽娟, 周晓俊, 何宋兵. 机器人单切口加一孔与腹腔镜多孔全结肠切除术治疗慢传输型便秘的短期疗效比较[J/OL]. 中华结直肠疾病电子杂志, 2026, 15(04): 340-348.

Xiuqi Du, Xinyu Shi, You Hu, Suo Wang, Jinbing Sun, Runze Zhong, Ziang Ke, Mengting Wang, Liqian Mu, Lijuan Zhang, Xiaojun Zhou, Songbing He. Short-term outcomes of robotic single-incision plus one port versus multiport laparoscopic total colectomy for slow transit constipation[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2026, 15(04): 340-348.

目的

比较机器人单切口加一孔与腹腔镜多孔全结肠切除术(TC)治疗慢传输型便秘(STC)的短期临床疗效。

方法

采用回顾性频数匹配研究方法,收集2021年6月至2025年11月在苏州大学附属第一医院确诊为STC并接受TC手术治疗的50例患者临床资料,根据手术方式分为机器人单切口加一孔组(25例)和腹腔镜多孔组(25例)。比较两组患者基线资料,围手术期相关指标包括手术时间、术中出血量、疼痛评分、首次排便/下地/进食时间、住院时间,术后短期随访观察指标包括Wexner便秘评分(WCS)、完全自发排便次数(CSBM)、胃肠道生活质量指数(GIQLI)评分、Bristol粪便性状量表(BSFS)、切口美容评分。

结果

两组患者性别、身体质量指数(BMI)、美国麻醉医师协会分级(ASA)等基线资料比较差异均无统计学意义(均P>0.05);年龄组间存在一定差异(t=−2.025,P=0.048)。两组所有手术均成功施行,无中转开腹,术中均未发生严重并发症。与腹腔镜多孔组相比,机器人单切口加一孔组手术时间更长[(293.52±60.57)min vs.(235.56±56.31)min,t=3.504,P<0.001],但首次排便时间[(25.00±5.00)h vs.(28.92±6.94)h,t=−2.423,P=0.020]、首次下地时间[(42.52±12.43)h vs.(51.92±13.07)h,t=−2.606,P=0.012]及住院时间[(9.08±1.91)d vs.(11.84±2.98)d,t=−3.895,P<0.001]均短于腹腔镜多孔组。术中出血量、疼痛评分、术后3个月随访,两组WCS、CSBM、GIQLI评分,术后总体并发症情况比较,差异均无统计学意义(均P>0.05);切口美容评分具有统计学意义(Z=−3.830,P<0.001)。

结论

与腹腔镜多孔组相比,机器人单切口加一孔组治疗STC同样具备较好的安全性与可行性,并在术后快速康复、切口美容方面更具优势,可作为STC患者个体化微创治疗的优选方案之一。

Objective

To compare the short-term clinical efficacy of robotic single-incision plus one-port total colectomy (TC) versus multi-port laparoscopic total colectomy in the treatment of slow transit constipation (STC).

Methods

A retrospective study with frequency matching was conducted. The clinical data of 50 patients diagnosed with STC who underwent surgical treatment in the First Affiliated Hospital of Soochow University from June 2021 to November 2025 were collected. According to the surgical method, the patients were divided into the robot-assisted single-incision plus one-port group (25 cases) and the laparoscopic multi-port group (25 cases). Baseline data and perioperative indicators were compared between the two groups, including operative duration, intraoperative blood loss, pain score, time to first ambulation, first oral feeding and first defecation, and length of hospital stay. Short-term postoperative follow-up indicators covered the Wexner Constipation Score (WCS), complete spontaneous bowel movements (CSBM), Gastrointestinal Quality of Life Index (GIQLI), Bristol Stool Form Scale (BSFS), and incision cosmetic satisfaction score.

Results

There were no statistically significant differences between the two groups in baseline characteristics, including sex, body mass index (BMI), and American Society of Anesthesiologists (ASA) classification (P>0.05); however, age differed to some extent between the groups (t=−2.025, P=0.048). All operations were completed successfully without conversion to open laparotomy or severe intraoperative complications. Compared with the multi-port laparoscopic group, the robotic-assisted single-incision plus one-port group required longer operative duration [(293.52±60.57) min vs.(235.56±56.31) min, t=3.504, P<0.001]. However, the time to first defecation [(25.00±5.00) h vs.(28.92±6.94) h, t=−2.423, P=0.020], time to first ambulation [(42.52±12.43) h vs. (51.92±13.07) h, t=−2.606, P=0.012] and length of hospital stay [(9.08±1.91) d vs. (11.84±2.98) d, t=−3.895, P<0.001] were shorter in the laparoscopic multi-port group. No statistically significant intergroup differences were observed in intraoperative blood loss, pain scores, WCS, CSBM and GIQLI scores at the 3-month postoperative follow-up, as well as overall postoperative complications (P>0.05). The incision cosmetic satisfaction score showed a statistically significant difference between the two groups (Z=−3.830, P<0.001).

Conclusion

Compared with laparoscopic multi-port group, robot-assisted single-incision plus one-port group for STC is equally safe and feasible, and has more advantages in postoperative rapid recovery and incision cosmesis, which can be used as one of the preferred options for individualized minimally invasive treatment of patients with STC.

图1 纳入及筛选患者数据的流程图
图2 机器人单切口加一孔组手术操作示意图,黑色箭头为单切口操作组套,①②③分别对应机器人1、2、3号臂器械孔,红色箭头为腹腔镜操作孔
图3 机器人单切口加一孔组术后切口缝合图(皮内缝合)
图4 腹腔镜多孔组布孔示意图
图5 腹腔镜多孔组术后切口缝合图
表1 两组患者基线资料比较[
±s,例(%),MQ1Q3)]
表2 两组患者围手术期指标比较[
±sMQ1Q3)]
表3 两组患者术后并发症[例(%)]
表4 两组术后随访结果比较[MQ1Q3)]
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