机器人直肠癌前切除术经自然孔道拖出标本21例分析

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目的探讨达芬奇机器人下经腹直肠癌根治术经阴道或肛门拖出标本的安全性及有效性。方法回顾性分析2012年2月至2013年9月南京军区南京总医院行机器人经腹直肠癌切除术并经阴道或肛门拖出标本的21例病人临床资料。结果 21例病人中19例经肛门拖出手术标本,2例经阴道拖出。病人平均年龄(62.5±7.8)岁。所有病人均顺利完成手术,无一例中转开腹。手术平均时间(173.6±27.1)min,术中平均出血量(38.7±11.2)mL,标本获取淋巴结平均数目为(16.0±1.8)枚,标本上下切缘均为阴性,术后肛门首次排气时间(1.9±0.4)d,术后平均住院时间(4.2±1.3)d。结论机器人行经腹直肠癌切除术经阴道或肛门拖出标本安全可行,具有良好的可操作性及实用性。 Objective To investigate the safety and efficacy of transvaginal or anus tracheal ablation of radical abdominal rectal cancer under da Vinci robot. Methods The clinical data of 21 patients who underwent transabdominal rectal cancer resection and vaginal or anus-draining specimens were retrospectively analyzed from February 2012 to September 2013 in Nanjing General Hospital of Nanjing Military Region. RESULTS: Twenty-nine of 21 patients were surgically removed from the surgical specimens and 2 of them were vaginal removed. The average patient’s age (62.5 ± 7.8) years. All patients successfully completed the operation, without any conversion to open surgery. The mean operative time was (173.6 ± 27.1) min, mean intraoperative blood loss was (38.7 ± 11.2) mL, and the average number of lymph nodes obtained was (16.0 ± 1.8). The upper and lower margins of the specimens were all negative. (1.9 ± 0.4) d, average postoperative hospital stay (4.2 ± 1.3) d. Conclusion It is safe and feasible for the robot to drag the specimen through the vagina or anus through the resection of the abdominal rectal cancer and has good maneuverability and practicability.
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