通过介绍达芬奇机器人联合折刀位行经腹会阴直肠癌根治术(abdominoporinal resection，APR)(Miles手术)的临床经验，确定其可行性和安全性。

回顾分析2015年1月至2016年7月15例在解放军南京总医院普通外科行APR的患者临床资料，对此手术方式的可行性和安全性进行评估。

15例患者均顺利完成手术，手术时间150～190 min，平均(164.5 ± 20.4)min；术中出血量20～50 ml，平均(28.5 ± 9.4)ml；清扫淋巴结10～18枚，平均(14.7 ± 3.7)枚；造口排气时间4～40 h，平均(18.4 ± 10.7)h；首次排尿时间6～32 h，平均(13.3 ± 6.7)h；术后住院时间4～16 d，平均(6.6 ± 3.1) d。患者术后随访4～8周，术中及术后均无严重并发症，无肿瘤复发及死亡。

机器人联合折刀位行APR安全可行，具有术中出血少、并发症少、术后恢复快、术后住院时间短等优势。

Through introduce the clinical experience of Da Vinci robot combined with prone jackknife position for abdominoperineal resection of rectal cancer(miles operation), determine its safety and feasibility.

Fifteen patients who underwent abdominoperineal resection of rectal cancer in department of general surgery, Nanjing General Hospital of PLA from Jan. 2015 to Jul. 2016, were enrolled in this study . Their clinical data were retrospectively analyzed to assess the feasibility and safety of this novel surgical method.

15 patients were successfully completed the operation, the operation time was 150-190 min[mean (164.5 ± 20.4)min]; the intraoperative blood loss was 20-50 ml[mean (28.5 ± 9.4)m1]; the number of lymph nodes harvested was 10-18 per case (mean 14.7 ± 3.7); the colostomy exhaust time was 4-40 h [mean (18.4 ± 10.7)h]; the micturition time for the first time was 6-32 h [mean (13.3 ± 6.7)h]; the postoperative hospital stay were 4-16 d (6.6 ± 3.1)d . The patients were followed up for 4-8 weeks, no serious complications, no tumor recurrence and death.

Robot combined with prone jackknife position for abdominoperineal resection of rectal cancer is safe and feasible, with less bleeding, less bleeding in the perineal incision, less seepage volume of perineal incision, less complications, faster recovery, shorter hospital stay and other advantages.