手术机器人系统直肠癌切除术——经肛门拖出标本及手术机器人行吻合重建

目的总结对直肠癌施行经肛门拖出标本及达芬奇手术机器人系统下进行直肠重建的临床经验。方法回顾性分析2012年2-5月间15例在南京军区南京总医院接受机器人系统施行直肠癌根治术患者的临床资料。结果15例患者中男9例．女6例,年龄（61．5±9．2）岁。所有病例均顺利完成机器人手术．手术时间（154．7±10．6）min,术中出血量（17．3±6．5）ml,术后肛门排气时间（2.3±0．8）d．术后住院时间（3．3±0．6）d。标本内获取的淋巴结（15．0±1．2）枚／例,切缘均为阴性。术后所有患者均接受了4-8周的随访．无术后感染、吻合口瘘及切口疝等并发症,无近期死亡病例。结论达芬奇手术机器人系统以其独特的光源系统及灵活的器械操作．极大地降低了直肠癌手术的难度。

Totally robotic surgery for rectal cancer with transanal specimen extraction and robot-sewn anastomosis technique

Objective To summarize the clinical experience of transanal specimen extraction and introduce how to achieve the rectum reconstruction in robotic rectal cancer surgery. Methods Clinical data of 15 cases undergoing rectal cancer resection with the da Vinci robotic system in Jinglin Hospital between February 2012 and May 2012 were analyzed retrospectively. Results There were 9 males and 6 females with a mean age of （61.5±9.2） years old. All the cases underwent robotic surgery successfully without intraoperative conversion. The average operative time was （154.7±10.6） min with minimal blood loss （17.3±6.5） ml. The time to first flatus was （2.3±0.8） days postoperatively. The postoperative hospital stay was （3.3±0.6） days. The mean number of lymph node harvested from the surgical specimen was （15.0 ±1.2）. All the resection margins were negative. All the patients had postoperative follow-up ranging from 4 to 8 weeks. There were no postoperative infection, anastomotic leak, incision hernia, or short-term deaths. Conclusion da Vinci robotic system greatly reduces the difficulty of the rectal cancer surgery with its unique light source system and flexible equipment operation.