外科理论与实践

外科理论与实践 ›› 2018, Vol. 23 ›› Issue (01): 32-36.doi: 10.16139/j.1007-9610.2018.01.008

• 论著 • 上一篇    下一篇

基于胃十二指肠重叠法三角吻合的全机器人远端胃癌根治术的临床应用（附2例报告）

严超, 刘文韬, 杨中印, 倪震天, 徐玮, 毕任达, 郑亚南, 华子辰, 朱正伦, 冯润华, 姚学新, 陈明敏, 李琛, 燕敏, 朱正纲   

  1. 上海交通大学医学院附属瑞金医院外科,上海消化外科研究所,上海市胃肿瘤重点实验室,上海 200025
  • 收稿日期:2017-12-18 出版日期:2018-01-25 发布日期:2020-07-25
  • 通讯作者: 朱正纲,E-mail: zzg1954@hotmail.com;燕敏,E-mail: ym10299@163.com
  • 基金资助:
    上海交通大学医学院基金项目（13XJ10011）

Clinical application of totally robotic radical distal gastrectomy for gastric cancer using delta-shaped overlap gastroduodenostomy: a report of 2 cases

YAN Chao, LIU Wentao, YANG Zhongyin, NI Zhentian, XU Wei, BI Renda, ZHENG Yanan, HUA Zichen, ZHU Zhenglun, FENG Runhua, YAO Xuexin, CHEN Mingmin, LI Chen, YAN Min, ZHU Zhenggang   

  1. Shanghai Key Laboratory of Gastric Neoplasms, Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2017-12-18 Online:2018-01-25 Published:2020-07-25

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摘要： 目的 探讨基于胃十二指肠重叠法三角吻合的全机器人远端胃癌根治术临床应用的可行性和安全性。方法 回顾性分析2017年11月,2例使用达芬奇Si机器人手术系统,行全机器人远端胃癌根治术病人的临床资料。结果 病例1为33岁女性远端胃癌病人,病例2为77岁男性病人。两者均成功完成全机器人远端胃癌D2淋巴结清扫以及胃十二指肠重叠法三角吻合,手术时间分别为210 min和240 min。术中出血量20 mL和100 mL;淋巴结清扫数目为32枚和24枚。上、下切缘病理检查结果均未见癌残留。术后首次肛门排气时间3.0 d和2.5 d,进食流质时间4 d和5 d,术后住院6 d和8 d。两者均无术后并发症发生。结论 基于胃十二指肠重叠法三角吻合的全机器人远端胃癌根治术可行且安全,其临床价值有待进一步深入研究。

关键词: 胃肿瘤, 达芬奇机器人手术系统, 胃切除术, 胃十二指肠吻合术, 三角吻合术

Abstract: Objective To investigate the feasibility and safety of totally robotic radical distal gastrectomy for gastric cancer using delta-shaped gastroduodenostomy with overlap method. Methods The clinical data of 2 patients with gastric cancer who underwent totally robotic radical distal gastrectomy using Da Vinci Si robotic surgical system in November 2017 were retrospectively analyzed. Results The first case was 33-year-old female with distal gastric cancer, and the second case was 77-year-old male. Both successfully underwent totally robotic radical distal gastrectomy with D2 lymphadenectomy and delta-shaped gastroduodenostomy using overlap method. Total operating time was 210 min and 240 min with the intraoperative blood loss of 20 mL and 100 mL, the harvested lymph nodes of 32 and 24, respectively. Both had cancer-free resection margin pathologically. The first flatus passage time was 3.0 d and 2.5 d postoperatively with the liquid food for 4 d and 5 d, respectively. Postoperative hospital stay was 6 d and 8 d, respectively. No postoperative complication was found in two cases. Conclusions Totally robotic radical distal gastrectomy for gastric cancer with delta-shaped gastroduodenostomy using overlap method is feasible and safe. The further study is needed for the clinical value.

Key words: Stomach neoplasm, Da Vinci robotic surgical system, Gastrectomy, Gastroduodenostomy, Delta-shaped anastomosis

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