摘要
目的:探讨达芬奇机器人镜下手工吻合技术在远端胃切除毕Ⅱ式吻合中的可行性与安全性。方法:回顾分析2016年6月至2018年6月行达芬奇机器人镜下手工吻合的远端胃切除毕Ⅱ式吻合的100例胃癌患者的临床资料,收集分析临床数据,结合相关文献,评估其可行性与安全性。结果:100例患者均顺利完成手术,均于镜下通过手工吻合完成消化道重建(毕Ⅱ式吻合),无一例中转开腹。手术时间平均(185.3±19.4)min,残胃空肠吻合时间(20.9±6.0)min,术中出血量(61.7±33.4)mL,淋巴结清扫数量(25.8±7.9)枚,术后首次肛门排气时间(1.7±0.9)d,术后首次下床活动时间(1.4±0.7)d,术后首次进食流质时间(2.5±1.8)d,术后平均住院(6.5±3.6)d,术后3 d VAS疼痛评分分别为(3.2±0.9)、(2.0±0.6)、(1.3±0.5)。术后发生并发症3例,均保守治疗后痊愈。术后随访6个月,均无肿瘤复发及死亡。结论:达芬奇机器人镜下手工吻合技术在远端胃切除毕Ⅱ式吻合中的应用是安全、可行的,值得推广应用。
Objective:To explore the feasibility and safety of da Vinci robot endoscopic manual anastomosis in BillrothⅡanastomosis after distal gastrectomy.Methods:A retrospective analysis was done in the clinical data of 100 patients with gastric cancer who underwent endoscopic manual anastomosis in BillrothⅡanastomosis after distal gastrectomy by Da Vinci robot from Jun.2016 to Jun.2018.Clinical data were collected and analyzed.The feasibility and safety of this technique were evaluated in combination with relevant literature.Results:All the 100 patients completed the distal gastrectomy successfully.All these patients underwent gastrointestinal reconstruction(BillrothⅡanastomosis)by manual anastomosis under the endoscope,and none of them converted to open surgery.The total operation time was(185.3±19.4)min,anastomosis time of remnant stomach and jejunum was(20.9±6.0)min,intraoperative bleeding volume was(61.7±33.4)mL,number of lymph node dissection was(25.8±7.9),first anal exhaust time was(1.7±0.9)d,first ambulation time was(1.4±0.7)d,first fluid diet time was(2.5±1.8)d,postoperative hospital stay was(6.5±3.6)d.The pain VAS scores were(3.2±0.9),(2.0±0.6)and(1.3±0.5)in the first three days after surgery,respectively.Postoperative complications occurred in 3 cases,and were cured after conservative treatment.All patients were followed up for 6 months,and no tumor recurrence or death was found.Conclusions:The application of Da Vinci robotic endoscopic manual anastomosis in BillrothⅡanastomosis of distal gastrectomy is safe and feasible,and it is worth popularizing.
作者
刘江
王刚
程伟
赵健
王海锋
成汇
江志伟
LIU Jiang;WANG Gang;CHENG Wei(Deparment of General Surgery,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210002,China;Department of General Surgery,General Hospital of Eastern Theater Command)
出处
《腹腔镜外科杂志》
2020年第6期412-416,共5页
Journal of Laparoscopic Surgery
基金
江苏省社会发展重点病种规范化诊疗项目(BE2015687)
江苏省中医药局科技项目(JD201807)。
关键词
胃肿瘤
达芬奇机器人
毕Ⅱ式吻合
Stomach neoplasms
Da Vinci robotics
BillrothⅡanastomosis
