發(fā)布時(shí)間：2018-06-04 18:12

  本文選題：直腸腫瘤 + 機(jī)器人手術(shù)　； 參考：《中國(guó)普通外科雜志》2017年04期

【摘要】：目的:探討達(dá)芬奇機(jī)器人全腔鏡-單吻合手術(shù)治療直腸癌的安全與可行性及術(shù)后近期療效。方法:回顧性分析2016年1月—2017年2月在重慶醫(yī)科大學(xué)附屬第一醫(yī)院施行直腸癌手術(shù)的124例患者資料,其中有26例行達(dá)芬奇機(jī)器人手術(shù)(機(jī)器人組),另98例行傳統(tǒng)腹腔鏡手術(shù)(腹腔鏡組),比較兩組患者的相關(guān)臨床指標(biāo)。結(jié)果:兩組患者的基本臨床資料差異均無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05),具有可比性。與腹腔鏡組比較,機(jī)器人組手術(shù)時(shí)間較明顯延長(zhǎng)(273.5minvs.234.3min),住院總費(fèi)用明顯增加(8.2萬(wàn)元vs.7.2萬(wàn)元),但術(shù)中出血量(43.3mLvs.68.4mL),術(shù)后排氣時(shí)間(3.3dvs.4.4d)、進(jìn)流食時(shí)間(3.9dvs.5.4d)、下床時(shí)間(4.5dvs.6.8d)、拔除尿管時(shí)間(5.0dvs.6.8d)及術(shù)后住院時(shí)間(10.0dvs.12.3d)均明顯縮短(均P0.05)。兩組均無(wú)中轉(zhuǎn)開(kāi)腹;兩組的遠(yuǎn)切緣距離、切除淋巴結(jié)個(gè)數(shù)、環(huán)周切緣陽(yáng)性率及術(shù)后并發(fā)癥發(fā)生率均無(wú)統(tǒng)計(jì)學(xué)差異(均P0.05)。結(jié)論:機(jī)器人全腔鏡-單吻合用于直腸癌治療是一項(xiàng)安全且可行的手術(shù)方式,具有創(chuàng)傷小、術(shù)后恢復(fù)快、住院時(shí)間短等的優(yōu)點(diǎn),但遠(yuǎn)期療效需進(jìn)一步隨訪。
[Abstract]:Objective: to evaluate the safety and feasibility of complete endoscope-single anastomosis with Leonardo da Vinci robot in the treatment of rectal cancer. Methods: the data of 124 patients undergoing rectal cancer surgery in the first affiliated Hospital of Chongqing Medical University from January 2016 to February 2017 were retrospectively analyzed. There were 26 cases of Leonardo da Vinci robot operation (robot group) and 98 cases of traditional laparoscopic surgery (laparoscopic group). Results: there was no significant difference in basic clinical data between the two groups (P 0.05). Compared with the laparoscopic group, In the robot group, the operation time was significantly prolonged 273.5 min vs.234.3 min, the total hospitalization cost was significantly increased (82000 Yuan vs.7.2, but the intraoperative bleeding volume was 43.3 mLvs.68.4 mL / L, the postoperative exhaust time was 3.3dvs.4.4 dL, the feeding time was 3.9dvs.5.4dL, the time of getting out of bed was 4.5dvs.6.8dU, the time of extubation was 5.0dvs.6.8d) and the postoperative hospitalization time was 10.0dvs.12.3 d) All of them were shortened significantly (P 0.05). The distance between the two groups, the number of lymph nodes removed, the positive rate of circumferential margin and the incidence of postoperative complications were not significantly different between the two groups (all P 0.05). Conclusion: robotic endoscopy-single anastomosis is a safe and feasible surgical method for rectal cancer. It has the advantages of less trauma, faster postoperative recovery and shorter hospital stay, but further follow-up is needed.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院胃腸外科;云南省腫瘤醫(yī)院/昆明醫(yī)科大學(xué)第三附屬醫(yī)院結(jié)直腸外科/大腸癌臨床研究中心;
【分類(lèi)號(hào)】：R735.37

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