Zou G J, Ma R, Liu X Y, Yuan X P, Wang S J, Ma B, Chen Q Q, Zhang C J
Department of General Surgery, the First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China.
Department of Gastroenterology, the First Medical Centre of Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2024 Sep 10;104(35):3328-3333. doi: 10.3760/cma.j.cn112137-20240421-00944.
To investigate the efficacy of Da Vinci robotic transanal minimally invasive surgery (R-TAMIS) for rectal neoplasms. The patients of rectal neoplasms who underwent R-TAMIS and were regularly followed up at the First Medical Center of Chinese PLA General Hospital from January 2021 to January 2024 were retropectively selected. Follow-up visits were conducted at 1, 2, and 4 weeks postoperatively, and then every 3 months until January 20, 2024. The perioperative situation, postoperative histopathological results, and follow-up status of the patients were observed. A total of 17 patients were included, including 10 males and 7 females, aged 35-80 (59±13) years. Eleven patients underwent surgery using the da Vinci® Si robot, while 6 patients underwent surgery using the da Vinci® Xi robot. The height of the resected tumor from the anal verge [ ( )] was 3.5 (3.0, 3.8) cm. The total operative time was 55.0 (50.0, 55.0) minutes, the platform installation time was 32.5 (30.0, 35.0) minutes. The actual surgical operation time was 22.5 (20.0, 27.5) minutes. Intraoperative blood loss was 9.2 (5.0, 10.0) ml. The postoperative hospital stay was 3.2 (3.0, 3.8) days. The total treatment cost was (29 447±4 765) yuan. Two patients who achieved clinical complete remission after neoadjuvant chemoradiotherapy experienced incision dehiscence one week postoperatively, which was resolved after four weeks of rectal irrigation therapy. All surgical specimens were intact, and all resection margins were negative. A total of 44(31,73) weeks were followed up, without local recurrence or distant metastasis. Da Vinci robotic transanal minimally invasive local resection may be a safe and feasible treatment option for rectal neoplasms.
探讨达芬奇机器人经肛门微创手术(R-TAMIS)治疗直肠肿瘤的疗效。回顾性选取2021年1月至2024年1月在中国人民解放军总医院第一医学中心接受R-TAMIS并定期随访的直肠肿瘤患者。术后1周、2周和4周进行随访,然后每3个月随访一次,直至2024年1月20日。观察患者的围手术期情况、术后组织病理学结果及随访情况。共纳入17例患者,其中男性10例,女性7例,年龄35-80(59±13)岁。11例患者使用达芬奇®Si机器人进行手术,6例患者使用达芬奇®Xi机器人进行手术。肿瘤下缘距肛缘[( )]为3.5(3.0,3.8)cm。总手术时间为55.0(50.0,55.0)分钟,平台安装时间为32.5(30.0,35.0)分钟。实际手术操作时间为22.5(20.0,27.5)分钟。术中出血量为9.2(5.0,10.0)ml。术后住院时间为3.2(3.0,3.8)天。总治疗费用为(29447±4765)元。2例新辅助放化疗后达到临床完全缓解的患者术后1周出现切口裂开,经4周直肠冲洗治疗后愈合。所有手术标本完整,所有切缘阴性。共随访44(31,73)周,无局部复发或远处转移。达芬奇机器人经肛门微创局部切除术可能是治疗直肠肿瘤安全可行的选择。