探讨达芬奇机器人“3+1”模式在进展期远端胃癌根治术中的临床应用效果。方法：回顾性分 析甘肃省人民医院于 2019 年 1 月—2020 年 2 月收治的 72 例进展期远端胃癌患者临床资料，按手术方式分为达芬奇 机器人“3+1”模式组 24 例，达芬奇机器人“4+1”模式组 20 例，腹腔镜手术组 28 例。对三组患者的淋巴结检出情况、 术后资料进行比较。结果：达芬奇机器人“3+1”模式组检出淋巴结数为（23.13±4.18）枚，与达芬奇机器人“4+1” 模式组（24.55±5.48）枚及腹腔镜手术组（22.07±5.48）枚（P=0.164）相比无明显差异；达芬奇机器人“3+1”模 式组出血量与达芬奇机器人“4+1”模式组和腹腔镜手术组相比无明显差异；三组手术操作时间、术后吻合口或残端漏、 术后出血发生率及淋巴漏发生率无统计学差异。达芬奇机器人“3+1”模式组术后 48h 疼痛评分（0.40±0.16）明显 低于达芬奇机器人“4+1”模式组（1.33±0.18）和腹腔镜手术组（1.36±0.20），达芬奇机器人“3+1”模式组术后 平均住院时间（9.5±3.5）d，明显少于达芬奇机器人“4+1”模式组（15.4±4.9）d 和腹腔镜手术组（16.2±4.8）d， 差异具有统计学意义。结论：达芬奇机器人“3+1”在进展期远端胃癌根治术的应用安全可行，可进一步减少创伤， 加速术后快速康复，减轻患者经济负担。

To investigate the clinical effect of Da Vinci robotic “3+1” mode in advanced distal gastrectomy. Methods: The clinical data of 72 patients with advanced distal gastric cancer admitted to Gansu Provincial People’s Hospital from January 2019 to February 2020 were retrospectively analyzed. 72 patients were divided into three groups, Da Vinci robotic“3+1” mode group (n=24), Da Vinci robotic“4+1” mode group (n=20) and laparoscopic group (n=28). The detection of lymph nodes and postoperative data of the three groups were compared. Results: The number of lymph nodes detected in the “3+1” mode group was (23.13±4.18) per case, which was not significantly different from that in the “4+1” mode group (24.55±5.48) and laparoscopic group (22.07±5.48) (P=0.164). The amount of bleeding was not significantly different among the three groups. No significant difference on operative time, anastomotic leakage or stump leakage, postoperative bleeding and incidence of lymphatic leakage were found among the three groups. The pain score 48 hours after operation in “3+1” mode group (0.40±0.16) was significantly lower than that in “4+1” mode group (1.33±0.18) and laparoscopic group (1.36±0.20). The average postoperative hospital stay of Da Vinci robot “3+1” mode group (9.5±3.5) d was significantly less than that of Da Vinci robot “4+1” mode group (15.4±4.9) d and laparoscopic group (16.2±4.8) d, with significant differences. Conclusion: The application of Da Vinci robotic“3+1” in advanced distal gastrectomy is safe and feasible, which could further reduce trauma, accelerate postoperative recovery and reduce the economic burden of patients.

收稿日期：2021-03-22  录用日期：2021-10-22 

Received Date: 2021-03-22  Accepted Date: 2021-10-22 

基金项目：甘肃省人民医院院内科研项目（16GSSY2-5） 

Foundation Item: Scientific Research Project of Gansu Provincial People’s Hospital(16GSSY2-5) 

通讯作者：马云涛，Email：532005612@qq.com

Corresponding Author: MA Yuntao, Email: 532005612@qq.com

引用格式：郭进，詹渭鹏，狐鸣，等 . 达芬奇机器人“3+1”模式在进展期远端胃癌根治术中的临床应用 [J]. 机器人外科学杂志（中 英文），2022，3（5）：406-413. 

Citation: GUO J, ZHAN W P, HU M, et al. Clinical application of Da Vinci robotic“3+1”mode in advanced distal gastrectomy [J]. Chinese Journal of Robotic Surgery, 2022, 3 (5): 406-413.

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