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

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

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。

Objective:To investigate the feasibility,safety and technical operations of robotic-assisted radical gastrectomy for gastric stump cancer using Da Vinci robotic system.Methods:Th e 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.Th e 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.Th e gastric tube was removed on postoperative day one in all patients.Th e average time to postoperative ambulation was(1.3±0.2)d,to fi rst anal gas passage was(2.5±0.6)d,and to liquid intake was(2.7±0.5)d,and the average length of postoperativehospital 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 aft er 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.