机器人辅助胰腺微创手术使医患受益的新探讨  

Seeking Benefits From The Robotic Assisted Minimally Invasive Pancreatic Surgery For Both Doctors And Patients

作　　者：吴志翀[1] 沈柏用[1] 彭承宏[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科,上海200025

出　　处：《肝胆外科杂志》2015年第2期87-90,共4页Journal of Hepatobiliary Surgery

摘　　要：目的探讨机器人辅助胰腺微创手术给医患双方带来的益处。方法回顾总结本院358例达芬奇机器人系统辅助胰腺微创手术患者的临床资料(胰十二指肠切除术105例,胰中段切除术61例,胰体尾切除术145例,Beger’s术18例,肿块局部切除术29例)。探讨不同部位胰腺肿瘤在手术方式和消化道重建方式上的差异。进一步结合患者的临床资料(年龄、性别、手术时间、术中出血、术后住院时间、术后并发症等),体现机器人手术系统在胰腺微创手术中的价值。结果 358例患者中,良性肿瘤患者258例(72.07%),恶性肿瘤患者100例(27.93%),中转开腹有8例(2.23%)。术后出血二次手术10例(2.79%)。胰体尾良性肿瘤手术保脾率为83.81%。结论机器人辅助下各部位的胰腺良、恶性性微创手术都是安全、可行、有效的,对于提高胰体尾良性肿瘤的保脾率有着显著的优势,有利于控制术中出血和增加术者的操作信心。无论在减少患者术中暴露,还是提高医务人员工作效率方面都有独特的价值。机器人辅助胰腺微创手术对于医患双方都是双赢的。Objective To discuss the benefits from the robotic assisted minimaUy invasive pancreatic surgery for both doctors and patients. Methods Review the clinical data summary of the 358 patients, underwent robotic assisted minimally invasive pancreat- ic surgery in our hospital（ pancreaticoduodeneetomy in 105 cases, mid-pancreatectomy in 61 cases, distal pancreatectomy in 145 cases, Beget＇ s surgery in 18 cases and enuclearation in 29 cases）. Explore the diversities in the operation method and the type of the diges- tive reconstruction according to the tumors in different locations of the pancreas. Further integrate the patients clinical data（ age, gen- der, operative duration, intraoperative blood lose, postoperative hospital stay and complications）, in order to reflect the value of the ro- botic surgical system in minimally invasive pancreatic surgery. Results Among these 358 patients, 258 cases were benign （72. 07% ）, however other 1130 cases were malignant（27. 93% ）. 8 cases（2. 23% ） were convert to laparotomy. Reoperation were needed due to bleeding in 10 cases （2. 79% ）. The spleen-preserving rate was 83.81% in benign distal pancreatic tumors. Conclu- sions The robotic system assisted minimal invasive surgery is safe, feasible and curative in various pancreatic tumors, benign and ma- lignant. It shows significant advantages in improving the spleen-preserving rate in benign distal pancreatic tumors, as well as controlling the intaroperation bleeding and increasing the performer＇ s confidence. Also, we find it unique values whether in reducing the patients＇ intraoperative exposure, or saving the medical and human resources. The Robot-assisted minimally invasive pancreatic surgery is a win- win for both doctors and patients.

关 键 词：机器人 胰腺微创手术 医患 受益 

分 类 号：R658[医药卫生—外科学]