| 1 | 机器人辅助直肠癌切除经自然腔道取标本手术(NOSES)联合多脏器切除术的应用显示文摘目的探讨达芬奇机器人辅助直肠癌切除经自然腔道取标本手术(NOSES)联合多脏器切除术的安全性和可行性。方法回顾性收集2013年10月至2021年2月复旦大学附属中山医院结直肠外科收治的使用机器人辅助直肠癌NOSES手术患者的临床资料,选取术中进行多脏器联合切除的11例患者,分析其临床病理特征和围手术期相关结果。结果共有11例患者接受机器人辅助直肠癌NOSES手术联合多脏器切除术,其中男性2例(2/11),女性9例(9/11),平均年龄(56.0±11.2)岁,8例低位直肠癌(8/11),2例中位直肠癌(2/11),1例高位直肠癌(1/11)。术前合并糖尿病1例(1/11),高血压2例(2/11),冠心病1例(1/11)。全组患者均顺利完成机器人辅助直肠癌切除NOSES联合多脏器切除术,其中联合全子宫双附件切除4例,联合子宫切除术1例,联合小肠及全子宫双附件切除1例,联合肺转移灶切除1例,卵巢囊肿切除1例,胆囊切除1例,肝ALPPS手术1例,肝叶切除术1例。全组平均手术时间为(175.5±48.2)min,平均出血量为(33.6±19.1)mL。无中转开腹病例,全组无术中输血。所有患者上下切缘与环周切缘均为阴性。无围术期死亡。2例患者(2/11)发生术后并发症(1例小肠不全梗阻,1例肺部感染),均保守治疗后好转。术后平均排气时间(74.2±33.1)小时,术后平均住院时间为(5.9±0.9)天,术后平均辅助治疗开始时间为(18.3±5.4)日。术后病理TNM分期Ⅱ期2例(2/11),Ⅲ期4例(4/11),Ⅳ期5例(5/11)。结论有经验的外科团队在合适的直肠癌患者中施行机器人辅助直肠癌切除NOSES联合多脏器切除术安全可行。 | 武琦 陈伊教 朱德祥 韦烨 许剑民 | 2021 | 中华结直肠疾病电子杂志2021，10，6： | 4 |
| 2 | Robotic surgery for multi-visceral resection in locally advanced colorectal cancer:Techniques,benefits and future directions显示文摘Colorectal cancer accounts for 10%of diagnosed cancers globally and often presents as advanced disease,necessitating aggressive treatment.With both younger and healthier elderly patients being diagnosed,as well as potentially the need for salvage therapy post total neoadjuvant treatment,surgical options for cure include pelvic exenteration.Whilst typically performed via an open approach,there has been an increased utilisation of minimally invasive techniques including robotic surgery.Offering smaller in-cisions,reduced postoperative pain,and quicker recovery time than open surgery,robotic techniques have demonstrated lower blood loss,shorter hospital stays,and reduced morbidity.Moreover,the er-gonomic design of robotic systems provides surgeons with comfort during long procedures and increased precision.It also offers an increased opportunity for organ preservation and reconstruction whilst maintaining adequate oncological outcomes.As robotic technology continues to evolve and combines with artificial intelligence,it is poised to play an even more significant role in the management of complex colorectal cancer cases,improving survival and long-term outcomes. | Chahaya Gauci Praveen Ravindran Stephen Pillinger Andrew Craig Lynch | 2023 | Laparoscopic, Endoscopic and Robotic Surgery2023，6，4： | 0 |
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