达芬奇机器人手术系统在残胃癌治疗中的应用：附8例报告

目的:探讨达芬奇机器人在残胃癌根治术中应用的可行性、安全性及技术方法。方法:回顾性分析2017年1月—2018年3月收治的8例残胃癌行达芬奇机器人辅助下残胃癌根治术患者临床资料。结果:8例患者均成功施行达芬奇机器人辅助下残胃癌根治术,平均手术时间(237.8±11.0)min,平均术中出血量(147.5±28.2)mL,平均清扫淋巴结(32.3±7.6)枚。术后第1天均拔除胃管,首次下地活动时间平均(1.3±0.2)d,排气时间平均(2.5±0.6)d,首次进流食时间平均(2.7±0.5)d,平均住院时间(7.2±0.5)d。围手术期无死亡病例,术后均未出现腹腔内出血、腹腔感染、吻合口瘘、吻合口狭窄、肠梗阻、切口感染等并发症。8例患者随访6～12个月,期间无死亡病例,患者一般情况良好,未见肿瘤复发。结论:达芬奇机器人应用于残胃癌根治术中是安全、有效、可行的,且手术更加微创、并发症少。

Application of Da Vinci surgical system in treatment of gastric stump cancer: a report of 8 cases

Objective: To investigate the feasibility, safety and technical operations of robotic-assisted radical gastrectomy for gastric stump cancer using Da Vinci robotic system.    Methods: The clinical data of 8 patients with gastric stump cancer undergoing robotic-assisted radical gastrectomy using Da Vinci robotic system from January 2017 to March 2018 were retrospectively analyzed. Results: Robotic-assisted radical gastrectomy were successfully performed in all of the 8 patients using  Da Vinci robotic system. The average operative time was (237.8±11.0) min, average intraoperative blood loss was (147.5±28.2) mL, and the average number of dissected lymph nodes was 32.3±7.6. The gastric tube was removed on postoperative day one in all patients. The average time to postoperative ambulation was (1.3±0.2) d, to first anal gas passage was (2.5±0.6) d, and to liquid intake was (2.7± 0.5) d, and the average length of postoperative hospital stay was (7.2±0.5) d. No death occurred during the perioperative period, and no complications such as intra-abdominal hemorrhage, abdominal infection, anastomotic leakage, anastomotic stricture, intestinal obstruction, and wound infection occurred after operation. Conclusion: Using Da Vinci robotic system in radical gastrectomy for gastric stump cancer is safe, effective and feasible. The operation is more minimally invasive, less bleeding, less postoperative pain and less complications.