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目的分析应用手术机器人系统进行胃癌全胃切除与食管空肠Roux-en-Y吻合术的安全性及有效性。方法回顾性分析2011年5～11月南京军区南京总医院对20例胃癌病人应用达芬奇手术机器人系统进行胃癌全胃根治切除与食管空肠Roux-en-Y吻合术的临床资料。结果 20例胃癌病人施行了全机器人全胃切除及食管空肠吻合术,其中男13例,女7例;年龄平均(57.8±6.5)岁。手术时间平均(245.5±53.0)min,出血量平均(75.5±50.3)mL。无术中并发症发生,术后无吻合口漏、出血、腹腔感染等并发症,仅1例病人术后发生输入袢肠梗阻,经再手术治疗后治愈。术后住院时间平均(6.4±2.5)d。结论手术机器人系统具有视野清晰、操作灵活精准,利用其进行全胃切除后食管空肠吻合术,操作简便可靠。应用手术机器人系统可能是进行食管空肠吻合的最佳解决方案。

Reconstruction of esophagojejunostomy by robot-sewing technique in totally robotic total gastrectomy

??Reconstruction of esophagojejunostomy by robot-sewing technique in totally robotic total gastrectomy JIANG Zhi-wei, ZHAO Kun, WANG Gang, et al. Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Nanjing 210002, China
Corresponding author: JIANG Zhi-wei, E-mail: surgery34@163.com
Abstract Objective To analyze the feasibility of reconstruction of esophagojejunostomy by robot-sewing technique in totally robotic total gastrectomy for gastric cancer. Methods The clinical data of 20 cases of gastric cancer performed da Vinci robotic total gastrectomy including robot-sewn esophagojejunal Roux-en-Y anastomosis between May 2011 and November 2011 at Nanjing General Hospital of Nanjing Military Command were analyzed retrospectively. Results All robotic surgeries were accomplished in 20 cases successfully. Among them, 13 cases were men and 7 were women; the mean age (±SD) was (57.8±6.5) years. The mean (±SD) operation time was (245.5±53.0) mins with a mean (±SD) blood loss of (75.5±50.3) mL. There was neither intraoperative complication nor postoperative complication such as stoma leakage, bleeding, abdominal cavity infection and so on in all cases. Only one case was readmitted for complication of afferent loop intestinal obstruction and received reoperation. The mean (±SD) postoperative hospital stay was (6.4±2.5) days. Conclusion A robot-sewn anastomosis for esophagojejunostomy reconstruction in robotic total gastrectomy for gastric cancer is simple, safe and feasible. It may be a standard surgical technique for totally robotic total gastrectomy for gastric cancer.