手术机器人行直肠前切除并经肛门拖出直肠临床研究  

Totally robotic surgery for rectal cancer with transanal specimen extraction

作　　者：张雪峰[1] 吕赤[1] 张成[1] 蒋会勇[1] 高广荣[1] 李达[1] 何淼[1] 吕晨光[1] 李瑾[1] 

机构地区：[1]沈阳军区总医院普通外科,辽宁沈阳110015

出　　处：《中国实用外科杂志》2013年第10期871-873,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨手术机器人行直肠前切除经肛门拖出直肠标本的手术方法。方法回顾性分析沈阳军区总医院普通外科于2012年7～12月间16例直肠肿瘤病人采用达芬奇手术机器人系统行直肠前切除并经肛门拖出直肠标本的临床资料。结果16例中男9例，女7例。13例为直肠癌，2例为直肠绒毛管状腺瘤，1例为直肠神经内分泌瘤。年龄46—84岁，体重指数（BMI）18．8～28．8。均顺利完成手术，手术时间160～610min，平均（220．4±24．5）min，术中出血量均在50mL以下，术后排气时间18—74h，平均（27．3±7．5）h，术后住院时间5～10d，平均（6．2±2．1）d，每例获取淋巴结2～39枚，平均（18．2±7．6）枚。TNM分期：Ⅰ期2例，Ⅱ期7例，Ⅲ期4例。所有标本切缘均为阴性。所有病例无局部手术并发症。结论采用达芬奇手术机器人系统切除直肠并经肛门拖出直肠标本的手术方法是安全可行的。Objective To investigate the clinical experience of transanal specimen extraction with robot-sewn anastomosis technique. Methods The clinical data of 16 cases performed rectal cancer resection by the da Vinci robotic system with transanal specimen extraction and robot-sewn anastomosis technique between July 2012 and December 2012 in General Hospital of Shenyang Military Region were analyzed retrospectively. Results There were 9 males and 7 females with age 46-84 years old, and BMI 18.8-28.8 kg/m2. All the cases （13 cases of rectal cancer, 2 cases of rectal villous tubular adenomas, 1 case of rectal carcinoid tumors） were performed robotic surgery successfully without intraoperative conversion. The operative time was 160-610 min [mean （220.4±24.5）min]. The blood loss was below 50mL. The time to first flatus was 18-74 hours [mean （27.3±7.5）hours] postoperatively. The postoperative hospital stay was 5-10 days [mean （6.2±2.1）days]. The number of lymph node harvested from the surgical specimen was 2-39 （mean 18.2±7.6）. TNM stage： 2 cases of stage Ⅰ, 7 cases of stage Ⅱ, 4 cases of stage Ⅲ. All the resection margins were negative. There was no local surgical complication. Conclusion Totally robotic surgery for rectal cancer with transanal specimen extraction is safe and feasible.

关 键 词：直肠肿瘤 达芬奇手术机器人系统 外科手术 

分 类 号：R6[医药卫生—外科学]