Yin Junqiang, Wu Hui, Tu Jian, Zou Changye, Huang Gang, Xie Xianbiao, He Yulong, Shen Jingnan
Department of Musculoskeletal Oncology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
Department of gastrointestinal surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China.
BMC Musculoskelet Disord. 2018 Jun 6;19(1):186. doi: 10.1186/s12891-018-2084-9.
Few studies have been done on robot-assisted sacral surgery. This study aims to evaluate the outcomes of seven patients with benign sacral or presacral tumors treated with a robotic surgical system at a single center.
All patients with benign sacral or presacral tumors who underwent transperitoneal resection (between June 2015 and June 2016) using the da Vinci Si HD robotic surgical system (Intuitive Surgical Inc.) were included in this retrospective study.
Seven patients with a mean age of 43.8 years (range: 22- 62 years) were included in this study. The operation time ranged from 60 to 335 min. Five out of these seven patients with presacral tumor underwent complete tumor resection by the da Vinci robotic surgical system, with a median blood loss of 52 ml. The other patients underwent excision of the presacral tumor by the da Vinci robotic surgical system, followed by a posterior approach, with a median blood loss of 675 ml. The histological diagnosis was schwannoma of the sacral nerve in five cases (71.5%). The other two cases were chordoma and solitary fibroma of the sacrum, respectively. No perioperative or postoperative complications were encountered. The average hospitalization stay was 5.7 days. No recurrences were found at follow-up 24 to 31 months later.
Robot-assisted minimally invasive sacral surgery can provide precise dissection of the tissue under a perfect view. It is a technically feasible procedure that is associated with minimal blood loss, fewer injuries and short hospitalization. It is particularly suitable for presacral benign tumors.
关于机器人辅助骶骨手术的研究较少。本研究旨在评估在单一中心使用机器人手术系统治疗的7例良性骶骨或骶前肿瘤患者的治疗效果。
本回顾性研究纳入了2015年6月至2016年6月期间使用达芬奇Si HD机器人手术系统（直观外科公司）经腹切除的所有良性骶骨或骶前肿瘤患者。
本研究纳入了7例患者，平均年龄43.8岁（范围：22 - 62岁）。手术时间为60至335分钟。这7例骶前肿瘤患者中有5例通过达芬奇机器人手术系统实现了肿瘤完全切除，术中失血中位数为52毫升。其他患者先通过达芬奇机器人手术系统切除骶前肿瘤，然后采用后路手术，术中失血中位数为675毫升。组织学诊断为骶神经鞘瘤5例（71.5%）。另外两例分别为骶骨脊索瘤和孤立性纤维瘤。未发生围手术期或术后并发症。平均住院时间为5.7天。在24至31个月的随访中未发现复发。
机器人辅助微创骶骨手术能够在完美视野下对组织进行精确解剖。这是一种技术上可行的手术，具有失血少、损伤小、住院时间短的特点。特别适用于骶前良性肿瘤。
