达芬奇机器人手术系统在顽固性便秘外科治疗中的应用:基于10例患者的回顾性分析  

Application of the da Vinci■ robotic surgical system in the treatment of intractable constipation:a retrospective analysis of 10 cases

作　　者：肖国栋 童卫东 黄彦森 李庆 李凡 Xiao Guodong;Tong Weidong;Huang Yansen;Li Qing;Li Fan(Department of General Surgery,Daping Hospital of Army Medical University(Army Medical Center),Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院(陆军特色医学中心)普通外科,重庆400042

出　　处：《结直肠肛门外科》2024年第3期303-310,共8页Journal of Colorectal & Anal Surgery

基　　金：国家自然科学基金项目(82370547);陆军军医大学科技创新能力提升专项项目(2022XLC05);重庆市自然科学基金项目(CSTB2023NSCQ-ZDJ0012)。

摘　　要：目的分析达芬奇机器人手术系统在顽固性便秘患者外科治疗中的应用效果。方法回顾性分析2016年7月至2024年4月因顽固性便秘接受机器人手术的10例患者的临床资料,患者的主要诊断情况:慢传输型便秘2例,成人特发性巨结肠1例,混合型便秘4例,直肠内脱垂3例。记录每位患者的基本信息、术中情况和术后恢复情况。患者的术后随访通过门诊或电话进行。结果10例患者中,4例既往有腹部手术史;3例接受全结肠切除术,1例接受次全结肠切除术;2例接受完全机器人手术。所有患者均未中转开腹。1例接受全结肠切除术的患者既往有腹部手术史,术中回肠系膜意外出血后出现低血压。1例患者术后出现炎性肠梗阻,保守治疗后好转。2例接受全结肠切除术的患者术后出现腹泻,至术后1年左右逐渐缓解。获得有效随访的8例患者中,患者自我报告对手术治疗的效果满意。结论对于顽固性便秘患者,应用达芬奇机器人手术系统开展全结肠切除术、次全结肠切除术、腹侧直肠补片固定术等术式安全可行。Objectives To evaluate the effectiveness of the da Vinci®robotic surgical system in the treatment of patients with intractable constipation.Methods A retrospective analysis was performed on the clinical data of 10 patients who underwent robotic surgery for intractable constipation between July 2016 and April 2024.The primary diagnoses of the patients included 2 cases of slow transit constipation,1 case of adult idiopathic megacolon,4 cases of mixed constipation,and 3 cases of internal rectal prolapse.Basic information,intraoperative conditions,and postoperative recovery of each patient were recorded.Postoperative follow-up was conducted through outpatient visits or telephone interviews.Results Among the 10 patients,4 had a history of abdominal surgery;3 underwent total colectomy,and 1 underwent subtotal colectomy;2 underwent totally robotic surgery.No conversion to open surgery was required in any of the patients.One patient with a history of abdominal surgery who underwent total colectomy experienced hypotension due to accidental hemorrhage from the ileal mesentery during the surgery.One patient developed inflammatory intestinal obstruction postoperatively,which improved after conservative treatment.Two patients who underwent total colectomy experienced diarrhea postoperatively,which gradually resolved within approximately 1 year after surgery.Among the 8 patients with effective follow-up,all self-reported satisfaction with the surgical outcomes.Conclusion In patients with intractable constipation,the da Vinci®robotic surgical system is safe and feasible to carry out surgical procedures such as total colectomy,subtotal colectomy,and ventral mesh rectopexy.

关 键 词：顽固性便秘 达芬奇机器人手术系统 全结肠切除术 次全结肠切除术 腹侧直肠补片固定术 

分 类 号：R574.6[医药卫生—消化系统]