腹腔镜超声在机器人辅助腹部肿瘤微创治疗中的应用  

Application of laparoscopic ultrasound in robot-assisted minimally invasive therapy for abdominal tumors

作　　者：高楠[1,2] 牟培源[2] 白媛媛[2] 周宁新[2] 

机构地区：[1]辽宁医学院研究生院,辽宁省锦州市121001 [2]中国人民解放军火箭军总医院全军肝胆胃肠病专科中心,北京市100088

出　　处：《世界华人消化杂志》2016年第12期1926-1930,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨腹腔镜超声在机器人辅助腹部肿瘤微创治疗中的临床应用.方法:对41例患者(肝门部胆管癌16例,肝占位15例,胰腺占位9例,腹膜后占位1例)行腹腔镜超声引导机器人辅助腹部肿瘤微创治疗.肿瘤治疗前经腹腔镜超声全面探查肿瘤精确部位、数量及其与邻近组织关系,术中实时引导肿瘤治疗路径,治疗后即刻经腹腔镜超声初步评价疗效.术后用超声、增强CT/MRI及血生化等进行临床疗效评价.结果:41例患者在腹腔镜超声引导下均成功完成机器人辅助腹部肿瘤微创治疗,手术成功率100%.其中10例患者在腹腔镜超声扫查下发现术前未预期病情,改变原手术方式,手术方式纠正率24.39%(10/41).围手术期无死亡病例,术后超声、增强CT/MRI均未见异常改变,生化指标趋于正常,术中及术后均未见严重并发症,患者生活质量改善,生存状况满意.结论:腹腔镜超声在机器人辅助腹部肿瘤微创治疗中不仅可引导手术方式选择,而且有助于提高术中安全性、减少术后并发症并延长无瘤生存时间,从而更利于提高机器人微创手术的临床疗效.AIM：To assess the clinical application of laparoscopic ultrasound in robot-assisted minimally invasive therapy for abdominal tumors.METHODS：A total of 41 patients（16 patients with hilar cholangiocarcinoma,15 patients with hepatic tumors,9 patients with pancreatic tumors,and 1 patient with retroperitoneal tumor） underwent laparoscopic ultrasoundguided robot-assisted minimally invasive therapy for abdominal tumors.Laparoscopic ultrasound was used preoperatively to detect the number of lesions,and evaluate their location and relationship with surroundings tissue precisely.Also,by means of laparoscopic ultrasound,the surgical pathways were guided operatively,and preliminary clinical effects were evaluated postoperatively.To assess clinical effi cacy,all patients were followed by contrast-enhanced CT/MRI,ultrasound,blood tests,etc.RESULTS：All laparoscopic ultrasound-guided procedures were performed successfully.Laparoscopic ultrasound discovered undetected lesions in 10 patients,which resulted in a change in operative strategy（10/41,24.39%）.No death occurred during the perioperative period.Abnormalities were not found postoperatively by ultrasound and contrastenhanced CT/MRI in all patients.Laboratory studies demonstrated that blood biochemical indicators decreased to normal range gradually.No severe complications occurred in both intraoperative and postoperative periods.Allpatients survived,and their life quality was improved signifi cantly.CONCLUSION：Laparoscopic ultrasound could not only guide operative strategy,but also help to decrease complications and prolong diseasefree survival in the postoperative period.This technique provides a safe surgical procedure,and the therapeutic effects could be improved by application of laparoscopic ultrasound in robot-assisted minimally invasive therapy for abdominal tumors.

关 键 词：腹腔镜超声 机器人 微创 肿瘤 

分 类 号：R730.56[医药卫生—肿瘤] TP242[医药卫生—临床医学]