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新型达芬奇 Xi 机器人手术辅助直肠癌低位前切除术及经阴道标本取出术的早期结果:初步临床经验。

Early results of novel robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction by using Da Vinci XI: initial clinical experience.

机构信息

University of Health Sciences, Antalya Training and Research Hospital, Departments of General Surgery and Organ Transplantation - Antalya, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2021 Jul;67(7):971-974. doi: 10.1590/1806-9282.20210325.

Abstract

OBJECTIVE

The aim of this study is to evaluate the early results of robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction, regarding the operative time, operative and early postoperative complications, hospital stay, and pathological reports in a series of 10 patients.

METHODS

From November 2016 to October 2019, case series study on patients diagnosed with RC was included in this study. All robotic-assisted low anterior resection of the rectum, vaginal removal of the specimen, colorectal anastomosis, and loop ileostomies were performed using the Da Vinci XI system.

RESULTS

The mean age of patient was 64.8 (58-72) years. Low anterior resection was performed to seven patients, and very low anterior resection was performed to three patients. Total mesorectal excision of the rectum, transvaginal specimen extraction, transanal anastomoses, and protective ileostomy were performed in all 10 patients. The mean operative time was 275±30.50 min, and estimated blood loss was 50±10.50 mL. No patient required conversion to conventional surgery. Negative circumferential resection, proximal, and distal margins were accomplished negative. Mean number of lymph nodes harvested was 20±5.5. According to the pathological reports, all were adenocarcinoma. T1 stage was 80.0%, and T2 stage was 20.0%. Lymph node metastasis accounted for 80.0%.

CONCLUSIONS

To our literature search, this is the first study reporting the early outcomes of the novel robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction by using the Da Vinci Xi system. It can be performed safely and successfully in selected patients by providing an excellent cosmetic body image, which may be important for women.

摘要

目的

本研究旨在评估达芬奇 Xi 系统辅助下机器人经阴道低位直肠前切除及标本取出术治疗直肠癌的早期结果,包括 10 例患者的手术时间、手术和早期术后并发症、住院时间以及病理报告。

方法

本研究为 2016 年 11 月至 2019 年 10 月期间的病例系列研究,纳入了诊断为直肠癌的患者。所有机器人辅助直肠低位前切除、阴道取出标本、结直肠吻合和回肠造口术均采用达芬奇 Xi 系统进行。

结果

患者的平均年龄为 64.8(58-72)岁。7 例患者行低位前切除术,3 例患者行超低位前切除术。所有患者均行直肠全系膜切除、经阴道标本取出、经肛门吻合和保护性回肠造口术。手术时间平均为 275±30.50 分钟,估计出血量为 50±10.50 毫升。无患者需要转为传统手术。所有患者均获得阴性环周切缘、近端和远端切缘。平均淋巴结检出数为 20±5.5 枚。根据病理报告,均为腺癌。T1 期占 80.0%,T2 期占 20.0%。淋巴结转移占 80.0%。

结论

根据我们的文献检索,这是第一项使用达芬奇 Xi 系统报道新型机器人辅助经阴道低位直肠前切除及标本取出术治疗直肠癌的早期结果的研究。该手术方法可安全、成功地应用于选择的患者,为患者提供良好的美容体型,这对女性可能很重要。

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