直肠癌的手术治疗:达芬奇机器人手术的应用及其与腹腔镜手术的优劣  

Surgical treatment of rectal cancer:application of da Vinci■ robotic surgery and its pros and cons versus laparoscopic surgery

作　　者：张之远 冯青阳[1,2] 许剑民 Zhang Zhiyuan;Feng Qingyang;Xu Jianmin(Department of Colorectal Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Shanghai Engineering Research Center of Colorectal Cancer Minimally Invasive Technology,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院结直肠外科,上海200032 [2]上海市结直肠肿瘤微创工程技术研究中心,上海200032

出　　处：《结直肠肛门外科》2024年第3期259-263,共5页Journal of Colorectal & Anal Surgery

摘　　要：结直肠癌是我国高发的恶性肿瘤,以直肠癌占多数。外科手术是直肠癌最主要的治疗方式,而且微创手术已成为主流。腹腔镜手术在临床中应用广泛,但是其在部分直肠癌,尤其是中低位直肠癌的治疗中仍存在一定的局限性。相比之下,达芬奇机器人手术系统凭借其操作灵活稳定、高清三维成像、机械臂的多活动自由度等优点,能够实现在狭小的盆腔内进行精细的手术操作,具有临床应用优势。本文阐述机器人手术在直肠癌中的应用概况,并从学习曲线和主刀医师的疲劳程度、术中情况、术后短期恢复效果、手术并发症、肿瘤学结局等角度论述机器人手术与腹腔镜手术治疗直肠癌的优劣。Colorectal cancer is a highly prevalent malignancy in China,with rectal cancer accounting for the majority.Surgical resection is the primary treatment for rectal cancer,and minimally invasive surgery has become the mainstream approach.Laparoscopic surgery is widely used in clinical practice,but it still has certain limitations in the treatment of some rectal cancers,especially in the middle and lower rectal cancer.In contrast,the da Vinci®robotic surgical system,with its advantages of flexible and stable operation,high-definition three-dimensional imaging,and multiple degrees of freedom of the robot arm movement,enables precise surgical manipulations in the confined space of the pelvic cavity,demonstrating clinical advantages.This article elaborates on the application of robotic surgery in rectal cancer and discusses the pros and cons of robotic surgery versus laparoscopic surgery for rectal cancer from the perspectives of the learning curve,surgeon-in-chief fatigue,intraoperative conditions,short-term postoperative recovery,surgery-related complications,and oncologic outcomes.

关 键 词：直肠癌 达芬奇机器人手术 腹腔镜手术 

分 类 号：R735.3[医药卫生—肿瘤]