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中华腔镜外科杂志(电子版) ›› 2022, Vol. 15 ›› Issue (06): 381 -384. doi: 10.3877/cma.j.issn.1674-6899.2022.06.013

病例报告

达芬奇机器人治疗胃癌合并低位直肠癌一例
张旭1, 龚航军1,(), 韩刚1   
  1. 1. 200120 上海中医药大学附属曙光医院胃肠外科
  • 收稿日期:2022-11-06 出版日期:2022-12-30
  • 通信作者: 龚航军

Experience and technique of simutaneous robot resection for synchronous gastric cancer and low rectal cancer: a case report

Xu Zhang1, Hangjun Gong1,(), Gang Han1   

  1. 1. Department of Gastrointestinal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200120, China
  • Received:2022-11-06 Published:2022-12-30
  • Corresponding author: Hangjun Gong
目的

总结一例胃癌合并低位直肠癌患者的诊治过程,探讨达芬奇机器人治疗胃癌合并低位直肠癌的可行性及安全性。

方法

回顾性分析上海中医药大学附属曙光医院胃肠外科2021年8月收治的一例胃癌合并低位直肠癌患者的临床诊治过程,结合相关文献分析达芬奇机器人用于胃癌合并直肠癌同期手术的可行性及安全性。

结果

患者同期行全机器人腹会阴联合直肠癌根治术+全胃切除术+食管空肠Roux-en-Y吻合术,手术时间450 min,术中出血量100 ml。术后无吻合口瘘、肠梗阻、切口感染等并发症,于术后11 d顺利出院。

结论

达芬奇机器人应用于胃、直肠多发癌有助于减少患者手术创伤,安全性高。

Objective

We investigated the feasibility and safety of the synchronous robotic resection of the low rectal and stomach malignancies by reporting a case of successful use of robotic surgery for low rectal cancer associated with gastric cancer.

Methods

To discuss the feasibility and safety of the synchronous robotic resection of the low rectal and stomach malignancies, we retrospctively make an analysis of the clinical data from a patient diagnosed as synchronous low rectal cancer and gastric cancer and relevant literature.

Results

The patient underwent totally robotic abdominoperineal resection and total gastrectomy. The operation time was 450 min and the intraoperative blood loss was 100 ml. There were no complications such as anastomotic leakage, intestinal obstruction and incisional infection after operation and he was successfully discharged on the 11th day after surgery.

Conclusions

Simultaneous robotic resection for synchrounous gastric cancer and rectal cancer is feasible and safe and could provide a better mininally invasive option for patients.

图1 胃癌合并低位直肠癌患者术前胃、肠镜检查注:A.胃体巨大结节样隆起,大小约6 cm×5 cm;B.红色箭头示胃窦大弯侧偏前壁Ⅱa型病变,大小约0.5 cm×0.5 cm; C.术前肠镜检查
图2 胃癌合并低位直肠癌患者术前胃、直肠增强CT检查注:A.红色箭头示胃体巨大结节样隆起;B.红色箭头示胃窦局部增厚
图3 胃癌合并低位直肠癌患者直肠增强CT检查注:A.增厚的直肠,浆膜面粗糙;B.红色箭头示肠系膜内肿大淋巴结,考虑肿瘤转移
图4 机器人全胃切除+腹会阴联合直肠癌根治术Trocar位置、术后腹壁外观注:A.胃手术机器人Trocar分布;R1.1号臂,置入无损伤抓钳;R2.2号臂,置入双极钳;R3.3号臂,置入摄像头;AS.辅助孔;R4.4号臂,置入超声刀;B.直肠手术机器人Trocar分布;R1.1号臂,置入无损伤抓钳;R2.2号臂,置入双极钳;R3.3号臂,置入摄像头;AS.辅助孔;R4.4号臂,置入超声刀;C.术后腹壁外观
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