机器人微创Ivor Lewis食管癌根治术的应用  

Application of robot-assisted minimally invasive Ivor Lewis esophagectomy for esophageal cancer

作　　者：张亚杰[1] 韩宇[1] 项捷[1] 李鹤成[1] ZHANG Yajie;HAN Yu;XIANG Jie;LI Hecheng(Department of Thoracic Surgery,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai,200025,P.R.China)

机构地区：[1]上海交通大学医学院附属瑞金医院胸外科,上海200025

出　　处：《中国胸心血管外科临床杂志》2018年第9期735-741,共7页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：上海市科学技术委员会医学引导类(西医)科技支撑计划(16411966100)

摘　　要：目的探究机器人辅助Ivor Lewis食管癌根治术的应用和疗效。方法回顾性分析2015年5月至2018年4月期间于上海交通大学医学院附属瑞金医院胸外科接受达芬奇机器人辅助Ivor Lewis食管癌根治术的70例中下段食管癌患者的临床资料,男54例、女16例,平均年龄(62.0±7.6)岁。其中40例采用机器人辅助吻合器胃食管胸内吻合术,30例采用机器人胃食管手工双层吻合。结果全组患者平均手术时间(308.7±60.6)min,平均出血量(190.0±95.1)ml,2例(2.9%)患者中转开胸手术。全组患者未发生院内及术后30 d内死亡。术后并发症发生率34.3%,其中吻合口瘘发生率8.6%。术后中位住院时间9.0(Interquartile Range,IQR,5.0)d。肿瘤平均大小为(3.2±1.5)cm,手术R0切除率为100.0%,总淋巴结平均清扫个数(19.3±8.7)枚。结论机器人辅助Ivor Lewis术安全可行,可获得满意的短期临床疗效。Objective To evaluate the effects of robot-assisted Ivor Lewis esophagectomy（RAILE） in surgical treatment of esophageal cancer. Methods We retrospectively analyzed the clinical data of 70 patients diagnosed with mid-lower esophageal cancer undergoing RAILE in the Department of Thoracic Surgery in Ruijin Hospital Affiliated to Shanghai Jiaotong University between May 2015 and April 2018. There were 54 males and 16 females at average age of62.0±7.6 years. Forty patients underwent circular end-to-end stapled intrathoracic anastomosis and 30 had a doublelayered, completely hand-sewn intrathoracic anastomosis. Results The mean operating time was 308.7±60.6 minutes.And blood loss was 190.0±95.1 ml. There were 2 patients who underwent conversion to thoracotomy. There was no inhospital and 30-day mortality. Overall complications were observed in 24 patients（34.3%）, of whom 6 patients（8.6%） had anastomotic leakage. The median length of hospitalization was 9.0（interquartile range, IQR, 5.0） days. The mean tumor size was 3.2±1.5 cm, and R0 resection was achieved in all patients. The mean number of totally dissected lymph nodes was19.3±8.7. Conclusion RAILE is safe and technically feasible with satisfactory perioperative outcomes.

关 键 词：机器人手术 Ivor LEWIS 食管癌 胃食管吻合 

分 类 号：R735.1[医药卫生—肿瘤]