达芬奇机器人手术系统辅助直肠癌根治术456例报道  

Application of da Vinci Robotic Surgical System in Radical Resection of Rectal Cancer:A Report of 456 Cases

作　　者：唐波[1] 曾冬竹[1] 张超[1] 雷晓[1] 甘露[1] 陈华[1] 罗华星[1] 李川[1] 余佩武[1] 

机构地区：[1]第三军医大学西南医院全军普通外科中心微创胃肠外科中心,重庆400038

出　　处：《中国普外基础与临床杂志》2016年第12期1419-1423,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的 总结达芬奇机器人手术系统辅助直肠癌根治术的临床疗效。方法 回顾性分析2010年3月至2016年3月期间于第三军医大学西南医院全军普通外科中心接受达芬奇机器人手术系统辅助直肠癌根治术的456例直肠癌患者的临床资料,总结患者的手术时间、术中出血量、淋巴结清扫数目、术后住院时间、术后并发症发生率等各项指标。结果 456例患者中,445例成功实施达芬奇机器人手术系统辅助直肠癌根治术,11例中转开腹（2.4%）。其中行经腹直肠前切除术322例（70.6%）,腹会阴联合直肠癌根治术126例（27.6%）,经腹直肠癌切除、近端造口、远端封闭术8例（1.8%）。手术时间为（192±60）min,术中出血量为（110±93）m L,清扫淋巴结（19±6）枚,远切缘距肿瘤边缘距离为（3.5±1.8）cm,术后下床活动时间为（2.9±1.5）d,肛门排气时间为（2.7±1.7）d,术后住院时间为（7.1±1.6）d,术后并发症发生率为8.8%（40/456）。术后431例患者获访（94.5%）,随访时间3~75个月,平均29.1个月。随访期间发生复发或转移70例（16.2%）,死亡60例（13.9%）。结论 达芬奇机器人手术系统辅助直肠癌根治术安全可行、创伤小、恢复快,临床疗效较满意。Objective To explore the efficacy of da Vinci robotic surgical system-assisted radical resection of rectal cancer. Methods The clinical data of 456 patients who received radical resection of rectal cancer by the da Vinci robotic surgical system at the Southwest Hospital from March 2010 to March 2016 were retrospectively analyzed. Operative time, operative blood loss, number of harvested lymph nodes, hospital stay, and morbidity were evaluated. Results da Vinci robotic surgical system-assisted radical resection of rectal cancer were successfully carried out in 445 patients, and other 11 patients were converted to open surgery （2.4%）. Of 456 patients, 322 patients underwent anterior resection of rectum procedure （70.6%）, 126 patients underwent abdominoperineal excision procedure （27.6%）, 8 patients underwent Hartmann procedure （1.8%）. The mean operative time was （192±60） min, the mean operative blood loss was （110±93） mL, the mean number of harvested lymph nodes were 19±6, the mean length between distal resection margin and tumor were （3.5±1.8） cm, the mean time for patients taking normal activity was （2.9±1.5） d, the mean time of passage of the first flatus was （2.7±1.7） d, the mean hospital stay was （7.1±1.6） d. Surgical complications occurred in 40 patients （8.8%）, and all the patients were recovery before leaving hospital. The mean follow-up time was 29.1 -month （3-75 months）. There were 70 patients suffered from occurrence or metastasis （16.2%）, and 60 patients died （13.9%）. Conclusion da Vinci robotic surgical system-assisted radical resection for rectal minimal trauma, fast recovery, and satisfactory clinical efficacy. cancer is a feasible and safe surgical procedure with the

关 键 词：达芬奇机器人手术系统 直肠癌根治术 直肠癌 疗效 

分 类 号：R735.37[医药卫生—肿瘤]