Single Docking Robotic Surgery for Rectal Cancer

單次設置之直腸癌機器人手臂手術

廖師賢(Shih-Hsien Liao) ； 陳奕彰(Yi-Chang Chen) ； 蔡元耀(Yuan-Yao Tsai) ； 黃郁純(Yu-Chun Huang) ； 張伸吉(Sheng-Chi Chang) ； 江驊哲(Hua-Che Chiang) ； 柯道維(Tao-Wei Ke) ； 王輝明(Hwei-Ming Wang) ； 陳自諒(William Tzu-Liang Chen)

《中華民國大腸直腸外科醫學會雜誌》 28卷4期 (2017/12) Pp. 185-190

https://doi.org/10.6312/SCRSTW.2017.28(4).10616

摘要

Purpose. Robotic surgery with advantages potentially overcoming the limitations of laparoscopic surgery in pelvis was reported in many studies, but it is difficult to approach a wide range of operative field in rectal surgery including colon mobilization and pelvic dissection in once setting. The objective of this study is to evaluate the safety and feasibility of the single docking robotic surgery with arm flipping method for rectal cancer. Materials and Methods. This is a retrospective review of the prospectively collected data of all patients who underwent single docking robotic rectal surgery at single-institution between January 2013 and October 2016. Baseline, perioperative and postoperative data were obtained for analysis. Result. A total of 37 patients with a mean age of 61.79 years and a body mass index of 24.58 kg/m^2 who underwent robotic rectal surgery between January 2013 and October 2016 were collected. The most common operation was total mesorectal excision (62.16%) followed by low anterior resection (29.73%), abdominoperineal resection (8.11%). The mean operative and docking time was 211.07 (range 150-500) minutes and 22.44 (range 6-80) minutes, respectively. The median number of lymph nodes harvested was 18 (range 4-25). The median length of hospital stay was 6 (range 3-26) days. Anastomotic leakage occurred in two patients and surgical site infection in one patient. We had no conversion in these robotic operations. Conclusions. Single docking robotic surgery with arm flipping method offers an adequate operative field, and it is safe and technically feasible for rectal cancer.

關鍵字

Single docking ； Robotic surgery ； Robotic rectal surgery ； Rectal cancer

並列摘要

目的：許多研究報導了機器人手臂手術有潛力克服腹腔鏡手術在骨盆中的局限性。但單次設置之機器人手臂手術較難以操作範圍較大的手術，如直腸癌手術中，包含腹腔中結腸的剝離及骨盆腔中直腸的剝離。本研究的目的是評估單次設置機器人手臂手術於直腸癌的安全性和可行性。材料和方法：這是對2013年1月至2016年10月間接受直腸癌機器人手臂手術所有患者的回顧性研究。針對病患基本資料、手術相關資料和術後數據進行分析。結果：收集了於2013年1月至2016年10月間接受直腸癌機器人手臂手術的病人共37例。平均年齡61.79歲，平均體重指數為24.58 kg/m^2。其中最常見的手術是全直腸切除術(62.16%)，其次為低前位切除術(29.73%)，腹部會陰切除手術(8.11%)。平均手術時間和機器人手臂設置時間分別為211.07 (150-500)分鐘和22.44 (6-80)分鐘。摘取淋巴結中位數為18 (4-25)顆。住院時間中位數為6 (3～26)天。吻合處滲漏2例，手術部位感染1例。我們在這些機器人手臂手術中沒有改變術式。結論：利用手臂翻轉的方式使單次設置之機器人手臂手術提供了適當的手術視野及範圍，並且對於直腸癌手術是安全和技術上可行的。

並列關鍵字

單次設置 ； 機器人手臂手術 ； 直腸癌機器人手臂手術 ； 直腸癌

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