机器人手术系统行胰腺钩突肿瘤切除术疗效评价(附6例报告)

The efficacy evaluation for pancreatic uncinate process tumor resection by using the robotic operation system:A report of 6 patients

目的探讨机器人手术系统行胰腺钩突肿瘤切除术的临床疗效。方法回顾性分析自2010年12月至2013年12月上海交通大学医学院附属瑞金医院完成的6例机器人手术系统辅助胰腺钩突肿瘤切除术的临床资料。结果 6例手术均顺利完成,无中转开腹。病人平均年龄51.7（40~64）岁,男性3例,女性3例。平均手术时间143.3（100~200）min;平均术中出血80（30~150）m L;平均术后住院天数23.8（13~44）d;术后2例出现B级胰瘘,1例出现C级胰瘘及肺部感染;无死亡病例。术后病理检查报告：4例为导管内乳头状黏液性肿瘤（IPMT）,1例为胰岛素瘤,1例为实性假乳头状瘤（SPT）。术后常规随访：根据手术时间分别随访2个月至2年,术后均未因相关并发症再次入院,均未发现肿瘤复发。结论机器人手术系统辅助胰腺钩突肿瘤切除术安全可行,成功率高,较传统开腹手术及腹腔镜手术,具有一定优势,但术后出现胰瘘等并发症概率仍较高。

ObjectiveTo evaluate the clinical effect of pancreatic uncinate process tumor resection by using therobotic operation system.MethodsThe clinical data of 6 patients who underwent pancreatic uncinate processtumorresection between December 2010 and December 2012 in Ruijin Hospital Affiliated to Shanghai Jiao TongUniversity School of Medicine were analyzed retrospectively.ResultsAll the surgeries were finished well with noconversion to laparotomy. The average age was 51.7 years old（40-64）. Three patients were male and 3 were female. Theaverage operation time was 143.3（100-200）min. The average bleeding during surgery was 80（30-150）m L. The averagehospital stay after surgery was 23.8d（13-44d）. Two patients suffered pancreatic leak（grade B） while 1 patient sufferedpancreatic leak（grade C） and pulmonary infection,but no patient dead. The pathology results：4 patients were IPMT,1patient was islet cell tumor,the other one was SPT. After follow up from 2 months to 2 years,no patient came back tohospital again and there was no reoccurrence of tumors.ConclusionPancreatic uncinate process tumor resection byusing robotic operation system is safe also with a high success rate. Compared with open or laparoscopic surgery,it hasmore advantages. However,the occurrence rate of pancreatic fistula after surgery is still high.