肥胖直肠癌患者行达芬奇机器人直肠全系膜切除术的近期疗效分析  

Analysis of short-term efficacy of Da Vinci robotic total mesorectal resection in obese patients with rectal cancer

作　　者：朱成章 张维胜[2] 杜斌斌[2] 胡东平[2] 燕东[2] 李晶晶[2] 杨熊飞[2] ZHU Chengzhang;ZHANG Weisheng;DU Binbin;HU Dongping;YAN Dong;LI Jingjing;YANG Xiongfei(First Clinical Medical College,Gansu University of Chinese Medicine,Lanzhou,Gansu 730000,China;Department of Anorectal Surgery,Gansu Provincial People′s Hospital,Lanzhou,Gansu 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]甘肃省人民医院肛肠科,甘肃兰州730000

出　　处：《现代医药卫生》2021年第1期15-18,共4页Journal of Modern Medicine & Health

基　　金：甘肃省兰州市科学技术局科技发展指导性计划项目(2017-ZD-42);甘肃省人民医院院内科研基金项目(20GSSY3-1,20GSSY4-9)。

摘　　要：目的分析肥胖直肠癌患者行达芬奇机器人直肠全系膜切除术的近期疗效。方法回顾性分析2018年1月至2020年1月甘肃省人民医院肛肠科收治的66例行达芬奇机器人直肠全系膜切除术患者的临床资料,按体重指数(BMI)分为肥胖组(BMI≥27 kg/m^ 2)、超重组(BMI 24~<27 kg/m ^2)和正常组(BMI 18~<24 kg/m^2),每组22例。观察比较3组患者基线特征、手术相关指标及术后相关并发症发生情况。结果3组患者性别、年龄、肿瘤大小、肿瘤距肛缘距离、pT分期、病理类型及分化程度,以及术后流质饮食时间、引流管拔除时间、术后住院时间比较,差异均无统计学意义(P>0.05)。肥胖组患者中转开腹手术率为4.55%,超重组和正常组无中转开腹手术者。3组患者手术时间、术中出血量、清扫淋巴结数比较,差异均有统计学意义(P<0.05)。3组患者术后肠梗阻、吻合口瘘、吻合口出血、切口感染、腹腔脓肿、尿潴留等相关并发症发生率比较,差异均无统计学意义(P>0.05)。结论肥胖直肠癌患者行达芬奇机器人直肠全系膜切除术的近期疗效无显著影响,但会明显延长手术时间及增加术中出血量。Objective To analyze the short-term efficacy of Da Vinci robotic total mesorectal resection in obese patients with rectal cancer.Methods The clinical data in 66 cases of Da Vinci robotic total mesorectal resection in the Gansu Provincial People′s Hospital from January 2018 to January 2020 were retrospectively analyzed.The patients were divided into the obesity group[body mass index(BMI)≥27 kg/m 2],overweight group(BMI 24-<27 kg/m 2)and normal group(BMI 18-<24 kg/m 2)according to BMI,22 cases in each group.The baseline characteristics,operation related indicators and occurrence situation of postoperative complications were observed and compared among 3 groups.Results There were no statistically significant differences in the gender,age,tumor size,tumor distance from anal margin,pT stage,pathological type,differentiation degree,time of postoperative fluid diet,time of drainage tube extubation and postoperative hospitalization time among the three groups(P>0.05).The conversion laparotomy rates of the obese group was 4.55%,and the overweight group and normal group had no case of convesion laparogomy.There were no statistically significant differences in postoperative intestinal obstruction,anastomotic fistula,anastomotic hemorrhage,incision infection,abdominal abscess,urinary retention and other related complications among the three groups(P>0.05).Conclusion The obese patients with rectal cancer have no significant effect on the short-term efficacy of Da Vinci robotic total mesorectal resection,but it will obviously prolong the operation time and increase the amount of intraoperative blood loss.

关 键 词：直肠肿瘤 肥胖症 达芬奇机器人 直肠全系膜切除术 治疗结果 

分 类 号：R657.1[医药卫生—外科学] R735.37[医药卫生—肿瘤]