目的：探讨机器人辅助经括约肌切除术治疗超低位直肠癌的疗效及优势。方法：回顾性分析2020 年1 月—2021 年6 月江苏省中医院普外科14 例行机器人辅助经括约肌切除术根治超低位直肠癌患者的临床资料。所有

患者术前均确诊为直肠恶性肿瘤，肿瘤下缘距肛缘2.5~5.0cm，均未累及肛门括约肌。患者术前均具有良好的肛门功能，观察手术时间、术中出血量、术后住院时间、术后相关并发症，以及术后进食、排尿、排气时间等情况。结果：所有手术均顺利完成，术中无中转开腹或改变手术方式，未增加手术通道，平均手术总时间为（291.1±68.1）min，术中平均出血量为（80.0±7.6）ml。患者麻醉清醒后，术后2h 可进少量流食。所有患者术后均无尿潴留表现，术后1d 拔出尿管，排尿顺畅，术后1d 均完成造口排气，术后平均住院时间为（5.9±2.3）d，14 例患者均行预防性回肠造口，于术后3~6 个月行造口还纳，均在规定时间内成功行造口还纳。所有患者术后肛门的控便功能均恢复良好，未出现结肛门吻合口狭窄、吻合口漏、伤口感染等相关并发症。结论：机器人辅助经括约肌间切除术治疗超低位直肠癌是安全、有效的。

Objective: To investigate the efficacy and advantages of robot-assisted intersphincteric resection in the treatment of ultra-low rectal cancer. Methods: The clinical data of 14 patients with ultra-low rectal cancer who underwent robotassisted intersphincteric resection in the General Surgery Department of Jiangsu Province Hospital of Chinese Medicine from January 2020 to June 2021 were retrospectively analyzed. All patients were diagnosed with rectal cancer, and the lower margin of the tumor was 2.5-5.0 cm to the anal margin, without anal sphincter involvement. The operative time, intraoperative blood loss,postoperative length of hospital stay, postoperative complications, postoperative feeding time, postoperative urination time and postoperative exhaust time were observed. Results: All surgeries were successfully completed. There was no conversion to open surgery or change of surgical method, and no surgical channel was added during operation. The average total operative time was (291.1±68.1) min, the intraoperative blood loss was (80.0±7.6) ml, and the average postoperative hospital stay was (5.9±2.3) d.Two hours after surgery, a small amount of fluid diet could be fed after awaking up from anesthesia．All the patients had their catheters removed on the first day after surgery and urinated smoothly without urinary retention．All patients underwent prophylactic ileostomy, and stoma reinstatement was successfully performed 3-6 months after the operation. Fecal incontinence of all patients recovered well after surgery, and no postoperative complications such as anastomotic stenosis, anastomotic fistula and wound infection occurred. Conclusion: Robot-assisted intersphincteric resection is safe and effective in the treatment of ultra-low rectal cancer.

收稿日期：2022-02-24 录用日期：2022-08-25

Received Date: 2022-02-24 Accepted Date: 2022-08-25

基金项目：湖北陈孝平科技发展基金（CXPJJH12000002-2020035）

Foundation Item: CHEN Xiaoping Foundation for the Development of Science and Technology of Hubei Province(CXPJJH12000002-2020035)

通讯作者：柳欣欣，Email：gorilla1999@hotmail.com

Corresponding Author: LIU Xinxin, Email: gorilla1999@hotmail.com

引用格式：陈鹏，柳欣欣，王立文，等. 机器人辅助经括约肌间切除术治疗超低位直肠癌的临床疗效分析[J]. 机器人外科学杂志（中英文），2023，4（3）：208-213.

Citation: CHEN P, LIU X X, WANG L W, et al. Clinical efficacy of robot-assisted intersphincteric resection for ultra-low rectal cancer[J]. Chinese Journal of Robotic Surgery, 2023, 4(3): 208-213.

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