达芬奇机器人辅助单孔加一孔直肠前切除术可行性分析  

Feasibility of single-incision robotic surgery for rectosigmoid tumor with da Vinci platform

作　　者：项世骏 韩超 张人超 岑刚 米兰 吴卫东[1] 裘正军[1] 黄陈 XIANG Shi-jun;HAN Chao;ZHANG Ren-chao(Department of Gastrointestinal Surgery,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200080,China)

机构地区：[1]上海交通大学医学院附属第一人民医院胃肠外科,上海200080

出　　处：《中国实用外科杂志》2023年第8期920-924,共5页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82072662,No.82103052);上海申康医院发展中心临床三年行动计划资助项目(No.SHDC2020CR4022);上海市教育委员会高峰高原学科建设计划项目(No.20191425)。

摘　　要：目的 探讨针对直肠乙状结肠交界处肿瘤行达芬奇Xi机器人辅助单孔加一孔直肠前切除术的可行性和安全性。方法 回顾性分析2021年7月至2022年2月在上海交通大学医学院附属第一人民医院接受达芬奇Xi机器人辅助单孔加一孔直肠前切除术的17例直肠乙状结肠交界处肿瘤病人的临床资料,并与同时期的23例行传统(多孔)机器人辅助直肠前切除术的直肠乙状结肠交界处肿瘤病人作对照,比较两组病人围手术期情况。结果 17例病人均顺利实施达芬奇Xi机器人辅助单孔加一孔直肠前切除术。与同时期23例行传统(多孔)机器人辅助直肠前切除术的病人比较,行机器人辅助单孔加一孔直肠前切除术的手术时间、操作时间、术中出血量、术后进食时间,术后住院时间、淋巴结清扫数目以及术后并发症发生率等方面差异无统计学意义,而装机时间[(15.9±4.0)min vs.(21.5±6.8)min,t=3.034,P=0.004]和术后首次排气时间[(1.2±0.6)d vs.(2.3±1.0)d,t=4.046,P<0.001]则显著减少。结论 达芬奇Xi机器人辅助单孔加一孔直肠前切除术治疗直肠乙状结肠交界处肿瘤同样安全、有效,而且与传统机器人辅助直肠前切除术相比,在提高装机效率和加快病人术后胃肠道功能恢复方面有潜在优势。Objective To assess the feasibility and safety of performing single-incision plus one port(SIPOP)operation for rectosigmoid tumor with the use of da Vinci Xi surgical system.Methods Data of 17 patients with rectosigmoid tumors who underwent SIPOP robot-assisted rectosigmoid rection with the da Vinci Xi robotic system from July 2021 to February 2022 in Shanghai General Hospital were retrospectively analyzed.The results of 23 patients with rectosigmoid tumor who underwent conventional(multi-port)robot-assisted anterior rectal resection during the same period were compared.Results All 17 patients underwent robot-assisted SIPOP anterior rectal resection successfully.Compared with traditional(multi-port)robot-assisted anterior resection,there was no significant difference in operation time console time,intraoperative blood loss,postoperative food intake time,postoperative hospital stay,the number of harvested lymph nodes,and the incidence of postoperative complications between the two groups.However,docking time[(15.9±4.0)min vs.(21.5±6.8)min,t=3.034,P=0.004]and first flatus time[(1.2±0.6)d vs.(2.3±1.0)d,t=4.046,P<0.001]were significantly reduced.Conclusion Da Vinci Xi robot-assisted SIPOP anterior rectal resection is safe and feasible in treating rectosigmoid tumors and has potential advantages in improving assembly efficiency and accelerating postoperative gastrointestinal function recovery of patients compared with conventional robot-assisted anterior rectal resection.

关 键 词：结直肠 机器人 直肠乙状结肠交界处肿瘤 单孔手术 直肠前切除术 

分 类 号：R6[医药卫生—外科学]