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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (01) : 9 -12. doi: 10.3877/cma.j.issn.1674-3946.2020.01.003

所属专题: 述评/论坛 总编推荐 机器人手术 文献

专家述评

达芬奇机器人直肠癌根治术的现状和发展
许剑民1,(), 常文举1, 鉴谧1   
  1. 1. 200032 上海复旦大学附属附属中山医院结直肠外科、结直肠癌中心
  • 收稿日期:2019-09-03 出版日期:2020-02-26
  • 通信作者: 许剑民

Updates and prospect of da Vinci robotic surgical system in radical resection of rectal cancer

Jianmin Xu1,(), Wenju Chang1, Mi Jian1   

  1. 1. Department of Colorectal Surgery, Colorectal Cancer Center, the Affiliated Zhongshan Hospital, Fudan University, Shanghai 200032, China
  • Received:2019-09-03 Published:2020-02-26
  • Corresponding author: Jianmin Xu
  • About author:
    Corresponding authors: Xu Jianmin, Email:
  • Supported by:
    National Natural Science Foundation of China(No.81602035); Clinical science and technology innovation project of Shanghai(No.SHDC12016104); Shanghai Minimally Invasive Engineering and Technology center for Colorectal cancer(No.17DZ2252600); Shanghai Science and Technology Committee Project(No.17411951300); National Key R&D Program(No.2017YFC0908205)
引用本文:

许剑民, 常文举, 鉴谧. 达芬奇机器人直肠癌根治术的现状和发展[J]. 中华普外科手术学杂志(电子版), 2020, 14(01): 9-12.

Jianmin Xu, Wenju Chang, Mi Jian. Updates and prospect of da Vinci robotic surgical system in radical resection of rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(01): 9-12.

达芬奇机器人手术是当前微创外科的最新潮流之一,它克服了传统腹腔镜的很多技术局限性,在提供立体视野、手术操作精细化和消除操作抖动等方面的优势显著。越来越多研究表明达芬奇机器人直肠癌手术安全可行。与传统腹腔镜手术相比较,机器人手术在降低中转开腹率、减少术后并发症率、改善术后生活质量等方面具有优势。在肿瘤远期生存方面,机器人术式与开腹手术、传统腹腔镜手术相当。近年来,机器人经自然腔道标本取出手术成为直肠癌治疗发展的重要分支。另外,在高速通信时代背景下,机器人系统将成为远程医疗的重点发展方向之一,积极推动远程会诊、学术交流、医院建设甚至就医模式的革新。

Introduction of the da Vinci robotic surgical system has revolutionized the field of minimally invasive surgery for rectal cancer. Da Vinci robotic technologies could help surgeons overcome the technical difficulties of conventional laparoscopic surgery, showing significant superiority in aspects of 3D visualization, articulated instruments and filtering operating tremor. Accumulated studies have confirmed the safety and feasibility of the da Vinci robotic surgery for rectal cancer. Compared with conventional laparoscopic surgery, the da Vinci robotic rectal surgery has latent advantage in decreasing conversion rate, reducing postoperative morbidity and improving postoperative life quality. In terms of oncological outcome, the robotic rectal surgery has shown comparable long-term outcomes with either open or laparoscopic surgery. At present, natural orifice specimen extraction surgery (NOSES) has been an important branch of robotic rectal surgery. In addition, in the era of high-speed communication, the robotic surgical system would be a key module in telemedicine, actively promoting the innovation of remote consultation, academic communication, hospital construction and even medical treatment model.

[1]
Staderini F, Foppa C, Minuzzo A,et al.Robotic rectal surgery: State of the art[J].World J Gastrointest Oncol,2016,8(11):757-771.
[2]
许剑民,冯青阳.达芬奇机器人直肠癌根治术与要点[J/CD].中华普外科手术学杂志(电子版),2017,11(1):8-12.
[3]
Wang L, Zhang Z, Gong L,et al.A Systematic Review and Bayesian Network Meta-Analysis: Short-Term and Long-Term Outcomes of Three Surgery Procedures Following Neoadjuvant Chemoradiotherapy for Rectal Cancer[J].J Laparoendosc Adv Surg Tech A,2019.[Epub ahead of print]
[4]
中国医师协会外科医师分会结直肠外科医师委员会,中国研究型医院学会机器人与腹腔镜外科专业委员会.机器人结直肠癌手术专家共识(2015版)[J].中国实用外科杂志,2015,35(12):1305-1310.
[5]
Jayne D, Pigazzi A, Marshall H,et al.Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer[J].JAMA,2017,318(16):1569-1580.
[6]
Jimenez-Rodriguez RM, Rubio-Dorado-Manzanares M, Diaz-Pavon JM,et al.Learning curve in robotic rectal cancer surgery: current state of affairs[J].Int J Colorectal Dis,2016,31(12):1807-1815.
[7]
Rouanet P, Bertrand MM, Jarlier M,et al.Robotic Versus Laparoscopic Total Mesorectal Excision for Sphincter-Saving Surgery: Results of a Single-Center Series of 400 Consecutive Patients and Perspectives[J].Ann Surg Oncol,2018,25(12):3572-3579.
[8]
Jones K, Qassem MG, Sains P,et al.Robotic total meso-rectal excision for rectal cancer: A systematic review following the publication of the ROLARR trial[J].World J Gastrointest Oncol,2018,10(11):449-464.
[9]
卓凡,李太原,孙焕奎,等.倾向性评分匹配达芬奇机器人与腹腔镜直肠癌低位前切除术的近期疗效比较[J].实用医学杂志,2019,35(9):1468-1472.
[10]
汤思哲,王仆,孔大陆.达芬奇机器人手术系统结直肠癌根治术的现状和展望[J].中国肿瘤临床,2019,46(7):370-374.
[11]
Park EJ, Cho MS, Baek SJ,et al.Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery[J].Ann Surg,2015,261(1):129-137.
[12]
Kim J, Baek SJ, Kang DW,et al.Robotic Resection is a Good Prognostic Factor in Rectal Cancer Compared with Laparoscopic Resection: Long-term Survival Analysis Using Propensity Score Matching[J].Dis Colon Rectum,2017,60(3):266-273.
[13]
Carmichael H, D’Andrea AP, Skancke M,et al.Feasibility of transanal total mesorectal excision (taTME) using the Medrobotics Flex? System[J].Surg Endosc,2019. [Epub ahead of print]
[14]
Liu Z, Efetov S, Guan X,et al.A Multicenter Study Evaluating Natural Orifice Specimen Extraction Surgery for Rectal Cancer[J].J Surg Res,2019,243:236-241.
[15]
George EI, Brand TC, Laporta A,et al.Origins of Robotic Surgery: From Skepticism to Standard of Care[J].JSLS,2018,22(4):e2018.
[16]
王国慧,易波,刘勇,等.国产手术机器人临床Ⅰ期研究(附103例报告)[J].中国实用外科杂志,2019,39(8):840-843.
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