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《中华消化外科杂志》2017年8月第16卷第8期论著·新技术

达芬奇机器人手术系统单孔直肠癌根治术的临床疗效

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引用本文:
唐波,李川,李平昂,等.达芬奇机器人手术系统单孔直肠癌根治术的临床疗效[J].中华消化外科杂志,2017,16(8):813-817.DOI:10.3760/cma.j.issn.1673-9752.2017.08.011.
【摘要】

目的:探讨达芬奇机器人手术系统单孔直肠癌根治术的临床疗效。
方法:采用回顾性描述性研究方法。收集2017年6月第三军医大学西南医院收治的国内首例行达芬奇机器人手术系统单孔直肠癌根治术患者的临床资料。术中采用腹腔镜辅助完成消化道重建。观察指标:(1)术中及术后情况。(2)随访及生存情况。采用门诊和电话方式进行随访,了解患者术后生存情况。随访时间截至2017年7月。
结果:(1)术中及术后情况:患者成功行达芬奇机器人手术系统单孔直肠癌根治术。手术时间为145 min,术中出血量为20 mL,未输血。术后第1天使用1次非甾体类镇痛药,术后首次下床活动时间为24 h,术后肛门首次排气时间为48 h,术后进流质食物时间为72 h,术后拔除盆腔引流管时间为4 d。无术后并发症发生。术后病理学检查:直肠中分化腺癌侵及浆膜层,环周切缘和直肠远切缘均为阴性,肠系膜淋巴结转移(肠系膜淋巴结送检16枚,其中1枚阳性);病理学分期为T4aN1M0期(Ⅲb期)。患者术后6 d出院。(2)随访及生存情况:患者术后随访1个月,生存良好。
结论:达芬奇机器人手术系统单孔直肠癌根治术安全可行,近期疗效较好。

【Abstract】

Objective:To explore the clinical efficacy of singleport Da Vinci robotic surgical system in the radical resection of rectal cancer.
Methods:The retrospective descriptive study was conducted. The clinical data of one patient with rectal cancer who was admitted to the Southwest Hospital of the Third Military Medical University in June 2017 was collected. The patient underwent the first case of radical resection of rectal cancer with the singleport Da Vinci robotic surgical system, and intraoperatively received laparoscopyassisted digestive tract reconstruction. Observation indicators: (1) intra and postoperative situations; (2) followup and survival. Followup using outpatient examination and telephone interview was performed to detect patients′ survival up to July 2017.
Results: (1) Intra and postoperative situations: the patient underwent successful singleport Da Vinci robotic radical resection of rectal cancer. The operation time and volume of intraoperative blood loss were 145 minutes and 20 mL, without blood transfusion. The using time of nonsteroidal analgesic drug, time for outofbed activity, time to anal exsufflation, time of fluid diet intake and time of pelvic drainage tube removal were 1 day, 24 hours, 48 hours, 72 hours and 4 days after operation, respectively. No postoperative complication was detected. Results of postoperative pathological examination: moderatedifferentiated rectal adenocarcinoma invaded serosal layer, with negative circumferential margin, negative distal margin of rectum and mesenteric lymph node metastasis (1 of 16 harvested lymph nodes was positive). Pathologic staging was T4aN1M0 (stage Ⅲb). The patient was discharged from hospital at postoperative day 6. (2) Followup and survival: the patient was followed up for 1 month, with a good survival.
Conclusion:Singleport Da Vinci robotic surgical system in the radical resection of rectal cancer is safe and feasible, with good short-term outcomes.

DOI:10.3760/cma.j.issn.1673-9752.2017.08.011
基金项目:第三军医大学西南医院临床新技术重点项目(SWH2014LC11、SWH2016YSCXZD-08)
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