机器人直肠癌手术的现状及发展

doi:10.16139/j.1007-9610.2025.03.15

摘要/Abstract

摘要：

机器人手术系统凭借三维视图、可旋转器械及稳定镜头等优势，在直肠癌经腹与经肛手术中逐步应用。相比传统腹腔镜，机器人系统可降低全直肠系膜切除术（TME）难度，改善盆腔自主神经保护，且远期疗效与腹腔镜相当。然而，其高昂成本与有限临床效益引发反思，尤其在手术时间延长、缺乏力反馈及性价比不足等方面存在争议。研究表明，机器人手术可能在肥胖、骨盆狭窄及低位直肠癌等复杂病例中更具优势。国产手术机器人的快速发展有望打破市场垄断，降低成本，并通过远程医疗拓展应用场景。未来需进一步筛选明确获益人群，结合高质量循证医学证据优化机器人手术的临床应用。

关键词: 直肠癌, 机器人手术, 腹腔镜手术, 微创外科, 全直肠系膜切除

Abstract:

Robotic surgical systems, with advantages such as 3D visualization, rotating instruments, and stable imaging, are increasingly utilized in transabdominal and transanal approaches for rectal cancer surgery. Compared to traditional laparoscopy, robotic systems could educe the technical difficulty of total mesorectal excision (TME) and enhance pelvic autonomic nerve preservation, while demonstrating comparable long-term outcomes. However, the high cost and limited clinical benefits have led to reflection. Controversies persist regarding prolonged operative time, lack of haptic feedback and limited cost-effectiveness. Studies suggest robotic surgery may benefit patients with complex conditions such as obesity, narrow pelvis or low rectal tumors. The rapid development of domestic surgical robots is expected to break market monopolies, reduce costs and expand applications through telemedicine. Future efforts should focus on identifying optimal patient cohorts and generating high-quality evidence to refine the clinical utility of robotic surgery.

Key words: Rectal cancer, Robotic surgery, Laparoscopic surgery, Minimally invasive surgery, Total mesorectal excision (TME)

中图分类号:

R735.37

徐世宁综述, 赵轩, 杨晓, 马君俊审校. 机器人直肠癌手术的现状及发展[J]. 外科理论与实践, 2025, 30(03): 272-276.

XU Shining, ZHAO Xuan, YANG Xiao, MA Junjun. Current status and development of robotic rectal cancer surgery[J]. Journal of Surgery Concepts & Practice, 2025, 30(03): 272-276.

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