机器人辅助胃癌根治术中双极血管闭合系统的应用价值  

Application value of bipolar vascular closure system in robotic-assisted radical gastrectomy for gastric cancer

作　　者：王天启 马胜杰 何亮[1] 吴迎奥 伊力哈尔 王权[1] WANG Tianqi;MA Shengjie;HE Liang(Department of Gastrointestinal and Colorectal Surgery,the First Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院胃结直肠外科,吉林长春130021

出　　处：《腹腔镜外科杂志》2025年第1期12-16,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨机器人辅助胃癌根治术中应用双极血管闭合系统的安全性及术后短期疗效。方法:采用回顾性描述性方法,收集2020年8月至2024年11月收治的125例胃癌患者的临床病理资料,患者均行机器人辅助胃癌根治术,术中应用双极血管闭合系统。观察短期手术结果、围术期并发症及术后病理资料。结果:125例胃癌患者中,47例(37.6%)行全胃切除术,9例(7.2%)行近端胃切除术,69例(55.2%)行远端胃切除术。中位手术时间240.0(200.0,281.5)min,中位消化道重建时间26.0(21.0,31.0)min,中位术中出血量100.0(72.5,150.0)mL。病理结果显示,中位清扫淋巴结数量28(20.0,37.0)枚,中位阳性淋巴结数量为0(0,3)枚。124例(99.2%)患者行D2淋巴结清扫术,1例(0.8%)患者行D1淋巴结清扫术,125例患者均行R0切除。术后2例(1.6%)患者发生吻合口漏,1例(0.8%)发生吻合口出血,2例(1.6%)发生吻合口狭窄,1例(0.8%)发生胃潴留,5例(4.0%)发生胸腔积液,2例(1.6%)发生肺栓塞,4例(3.2%)发生腹腔积液,1例(0.8%)发生胰瘘,1例(0.8%)发生肠麻痹,1例(0.8%)发生肠梗阻。中转开腹1例(0.8%),术后二次手术1例(0.8%),术后30 d内再次入院3例(2.4%),无术后30 d内死亡病例。结论:使用双极血管闭合系统行机器人辅助胃癌根治术具有良好的安全性与可行性。Objective:Robotic-assisted radical gastrectomy for gastric cancer has advantages over laparoscopic surgery in r educing short-term complications,decreasing intraoperative blood loss,and improving lymph node dissection.However,the ultrasonic energy devices used in robotic surgery are limited by flexibility and potential thermal injury risks.The bipolar vascular closure system,with its fully articulated design and low-energy vessel sealing capabilities,may reduce thermal damage and optimize the surgical process.However,its safety and short-term postoperative recovery effects require further validation.The aim of this study is to evaluate the safety and short-term outcomes of using the bipolar vascular closure system in robotic-assisted radical gastrectomy for gastric cancer.Methods:This retrospective descriptive study collected the clinical and pathological data of 125 gastric cancer patients who underwent robotic-assisted radical gastrectomy with bipolar vascular closure system between Aug.2020 and Nov.2024.All surgeries were performed by the same team.Observed outcomes included short-term surgical results,perioperative complications,and postoperative pathological data.Results:A total of 47 patients(37.6%)underwent total gastrectomy,9 patients(7.2%)underwent proximal gastrectomy,and 69 patients(55.2%)underwent distal gastrectomy.The median surgical time was 240.0(200.0,281.5)min,with a median time for gastrointestinal reconstruction of 26.0(21.0,31.0)min.The median intraoperative blood loss was 100.0(72.5,150.0)mL.Pathological findings revealed a median number of 28(20.0,37.0)lymph nodes harvested,with a median of 0(0,3)positive lymph nodes.A t otal of 124 patients(99.2%)underwent D2 lymph node dissection,and 1 patient(0.8%)underwent D1 lymph node dissection.All 125 patients had R0 resections.Postoperative complications included anastomotic leakage in 2 patients(1.6%),anastomotic bleeding in 1 patient(0.8%),anastomotic stricture in 2 patients(1.6%),gastric retention in 1 patient(0.8%),pleural effusion in 5 patient

关 键 词：胃肿瘤 胃癌根治术 机器人手术 双极血管闭合系统 

分 类 号：R735.2[医药卫生—肿瘤]