达芬奇机器人在食管外科中的应用  

Application of Da Vinci robotic surgical system in esophageal surgery

作　　者：徐杨 申翼[1] XU Yang;SHEN Yi(Department of Cardiothoracic Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)心胸外科,南京210002

出　　处：《医学研究生学报》2021年第1期1-7,共7页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81172032);江苏省自然基金(BK20181239)。

摘　　要：外科手术仍然是多种食管良恶性疾病的重要治疗措施。达芬奇机器人作为一种新兴的微创手术方式,在食管癌等食管疾病的外科治疗中有着越来越广泛的应用前景。达芬奇机器人手术系统提供的高清晰三维手术视野以及超越人手极限的机械旋转手臂,有助于保障手术操作的精准性、灵活性。国内外多家中心对达芬奇机器人辅助食管癌手术的经验进行了总结报道,并与传统的胸腹腔镜联合微创食管癌手术方式进行对比,尤其是在淋巴结清扫效果、术中出血量、术后并发症发生率、术后住院时间等方面进行了详细探讨,但是关于达芬奇机器人手术对于食管癌患者的远期预后是否存在明显优势尚无定论。文章从达芬奇机器人手术系统以及其在食管癌、食管良性疾病(贲门失弛缓症、食管平滑肌瘤、食管憩室)的应用等方面阐述并展望,为临床实践中更科学精准地运用提供参考。Surgery remains one of the most important treatments for certain benign and malignant diseases of esophagus.In recent years,Da Vinci robotic surgical system has been gradually developing as a significant method for minimally invasive surgery of esophageal diseases,including esophageal cancer.The Da Vinci robotic surgical system can provide 3 D surgical vision and mechanical rotating arms that superior to human hands,which may contribute to precision and flexibility of surgical operations.Recently,numerous centers have reported their experience in Robot-assisted minimally invasive esophagectomy(RAMIE),and compared the effect of lymph node dissection,the amount of intraoperative blood loss,the incidence of postoperative complications,and the length of postoperative hospital stay with the traditional thoraco-laparoscopic minimally invasive esophagectomy(TLMIE).However,whether RAMIE has a significant advantage in the long-term prognosis of patients with esophageal cancer remains controversial.Besides,Da Vinci robotic surgical system is also applied in the treatment of other esophageal diseases such as achalasia,esophageal leiomyoma and esophageal diverticula,providing more convenience for the operation and superior short-term outcomes.We look forward to more clinical studies concentrated on the long-term outcome of Da Vinci robotic surgical system for esophageal surgery,and a wider application of the Da Vinci robotic surgical system in our country.

关 键 词：达芬奇机器人 食管外科 微创手术 食管癌 食管良性疾病 

分 类 号：R655.4[医药卫生—外科学]