腹部无辅助切口经阴道拖出标本的机器人右半结肠癌根治术的临床研究^*

Clinical Study of Robotic Natural Orifice Specimen Extraction Surgery for Right Colon Cancer

摘要

目的 探讨腹部无辅助切口经阴道拖出标本的机器人右半结肠癌根治术的安全性和可行性。方法 纳入2022年1月1日至2025年1月31日在我院接受腹部无辅助切口经阴道拖出标本的机器人右半结肠癌根治术治疗的女性患者22例，通过收集并分析手术时间，术中出血量，中转开腹率，术后并发症，术后30 d死亡率，再入院率（术后30 d内手术相关非计划再入院）等指标评估手术的安全性和可行性。结果 手术均顺利完成，手术时间158 min（152～169 min），术中出血量53 mL（43～75 mL），无中转开腹，术后首次排气时间53.00 h（49.25～57.50 h），术后住院时间9.00 d（8.00～11.00 d），术后出现肠梗阻1例，未见吻合口瘘、吻合口出血、阴道出血、阴道感染、腹腔感染等其余并发症，术后30 d无死亡，也无手术相关非计划再入院。结论 腹部无辅助切口经阴道拖出标本的机器人右半结肠癌根治术是安全可行的。

Abstract

Objective To evaluate the safety and feasibility of robotic natural orifice specimen extraction surgery (NOSES) for right colon cancer. Methods Twenty-two female patients undergoing this procedure between January 1, 2022 and January 31, 2025 were enrolled. Safety and feasibility were assessed by analyzing operative time, intraoperative blood loss, conversion rate to open surgery, postoperative complications, 30-day mortality, and 30-day unplanned surgery-related readmission rate. Results All procedures were completed successfully. The median operative time was 158 min (152-169 min), and the median blood loss was 53 mL (43-75 mL). No conversions to open surgery occurred. The first postoperative flatus occurred at a median of 53.00 h (49.25-57.50 h), and the median postoperative hospital stay was 9.00 d (8.00-11.00 d). Postoperative complications included one case of intestinal obstruction. No anastomotic leakage, anastomotic bleeding, vaginal hemorrhage, vaginal infection, or abdominal infection was observed. There were no deaths within 30 days and no unplanned surgery-related readmissions. Conclusion Robotic NOSES for right colon cancer is safe and feasible.

关键词

右半结肠癌 / 机器人手术 / 经自然腔道取标本手术

Key words

Right colon cancer / Robotic surgery / Natural orifice specimen extraction surgery

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基金资助

*江西省卫生健康委科技计划(202210029)