目的：探讨免打结双倒刺线手工缝合法在机器人辅助根治性全胃切除术后的近期临床疗效。方法：回 顾性分析 2020 年 10 月—2023 年 7 月吉林大学第一医院普通外科中心胃结直肠外科行机器人辅助根治性全胃切除术 的 42 例胃体或贲门癌患者的临床病理资料，主要包括手术时间、吻合时间、术中出血量、术后住院时间、术后并 发症及随访情况。结果：手术时间（290±37）min，吻合时间（23±3）min，术中出血量 20（20，100）mL，术后住 院时间（8±1）d，术后并发症发生率为 33.3%（14/42）。42 例患者失访 2 例，其余 40 例患者随访时间 1~34 个月， 中位随访时间为 19 个月。结论：患者行机器人辅助根治性全胃切除术后，采用免打结双倒刺线手工缝合食管空肠 法重建消化道，不会增加并发症，且术后近期吻合口瘘和吻合口狭窄发生率较低。

Objective: To investigate the short-term clinical efficacy of double knotless barbed hand-suture after robotassisted total gastrectomy. Methods: Clinicopathological data of 42 patients who underwent total gastrectomy for gastric body or cardia cancer in the Department of Gastro-colorectal Surgery, General Surgery Center, the First Hospital of Jilin University from October 2020 to July 2023 was retrospectively analyzed. Operative time, anastomosis time, intraoperative blood loss, length of hospital stay, postoperative complications and follow-up were mainly observed and analyzed. Results: The operative time was (290±37) min, with the anastomosis time of (23±3) min, intraoperative blood loss of 20 (20, 100) mL, postoperative length of hospital stay of (8±1)d and the postoperative complication rate of 33.3% (14/42). There were 2 patients lost to follow-up among the 42 patients, 40 patients were followed up 1-34 months, with the median follow-up time of 19 months. Conclusion: After robot-assisted total gastrectomy, reconstruction of gastrointestinal tract using double knotless barbed handsuture method does not increase complications, and the incidence rate of anastomotic fistula and anastomotic stenosis is lower in the short term after surgery.

收稿日期：2024-01-19  录用日期：2024-06-06 

Received Date: 2024-01-19  Accepted Date: 2024-06-06 

基金项目：吉林省科技发展计划项目（YDZJ202402012CXJD） 

Foundation Item: Science and Technology Development Plan Project of Jilin Province(YDZJ202402012CXJD) 

通讯作者：何亮，Email：he_liang@jlu.edu.cn；王权，Email：wquan@jlu.edu.cn 

Corresponding Author: HE Liang, Email: he_liang@jlu.edu.cn; WANG Quan, Email: wquan@jlu.edu.cn 

引用格式：代洪智，赵银泉，孙璇，等 . 免打结双倒刺线手工缝合法在机器人辅助全胃切除术中的应用及疗效分析（附手术视频）[J]. 机器人外科学杂志（中英文），2024，5（5）：887-891. 

Citation: DAI H Z, ZHAO Y Q, SUN X, et al. Application and efficacy of double knotless barbed hand-suture method in robotassisted total gastrectomy(with surgical video)[J]. Chinese Journal of Robotic Surgery, 2024, 5(5): 887-891.

[1] ZHOU J F, SHI Y, TANG B, et al. Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: comparison of surgical performance and short-term outcomes [J]. Surg Endosc, 2014, 28(6): 1779-1787. 

[2] LUO R, LIU D N, YE S P, et al. Short- and long-term outcomes of totally robotic versus robotic-assisted radical distal gastrectomy for advanced gastric cancer: a mono-institution retrospective study [J]. World Journal of Surgical Oncology, 2019, 17(1): 188. 

[3] WANG J H, HE Y Q, YU D L, et al. Endoscopic retrograde cholangiopancreatography with balloon-assisted enteroscopy in patients with Roux-en-Y anastomosis and Whipple operation [J]. Medicine, 2020, 99(42): e22653. 

[4] Makuuchi R, Irino T, Tanizawa Y, et al. Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer [J]. Surgery today, 2019, 49(3): 187-196. 

[5] 杨闯 , 钱锦 , 汪洋 , 等 . 手工吻合在全腹腔镜下全胃切除术食管空 肠吻合中的应用 [J]. 中华胃肠外科杂志 , 2018, 21(9): 1068-1070. 

[6] 中国研究型医院学会机器人与腹腔镜外科专业委员会 , 中国抗 癌协会胃癌专业委员会 . 机器人胃癌手术中国专家共识 (2021 版 )[J]. 中华消化外科杂志 , 2022, 21(1): 1-9. 

[7] Zonca P, Maly T, Herokova J, et al. Reconstruction after total gastrectomy [J]. Bratisl Lek Listy, 2002, 103(11): 414-417. 

[8] WANG H, HAO Q, WANG M, et al. Esophagojejunostomy after laparoscopic total gastrectomy by OrVil™ or hemi-double stapling technique [J]. World J Gastroenterol, 2015, 21(29): 8943-8951. 

[9] Marangoni G, Villa F, Shamil E, et al. OrVil™-assisted anastomosis in laparoscopic upper gastrointestinal surgery: friend of the laparoscopic surgeon [J]. Surg Endosc, 2012, 26(3): 811-817. 

[10] Uyama I, Sugioka A, Fujita J, et al. Completely laparoscopic extraperigastric lymph node dissection for gastric malignancies located in the middle or lower third of the stomach [J]. Gastric Cancer, 1999, 2(3): 186-190. 

[11] 郑华龙 , 林嘉 , 黄昌明 . 机器人胃癌根治术消化道重建的技术 难点及其对策 [J]. 中华胃肠外科杂志 , 2022, 25(5): 392-395. 

[12] Omori T, Oyama T, Mizutani S, et al. A simple and safe technique for esophagojejunostomy using the hemidouble stapling technique in laparoscopy-assisted total gastrectomy [J]. Am J Surg, 2009, 197(1): e13-17. 

[13] Kumamoto T, Ishida Y, Igeta M, et al. Potential advantages of robotic total gastrectomy for gastric cancer: a retrospective comparative cohort study [J]. J Robot Surg, 2022, 16(4): 959-966. 

[14] HUANG Z N, HUANG C M, ZHENG C H, et al. Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life [J]. World J Gastroenterol, 2017, 23(39): 7129-7138. 

[15] Parisi A, Ricci F, Trastulli S, et al. Robotic total gastrectomy with intracorporeal robot-sewn anastomosis: a novel approach adopting the double-loop reconstruction method [J]. Medicine (Baltimore), 2015, 94(49): e1922. 

[16] Parisi A, Ricci F, Gemini A, et al. New totally intracorporeal reconstructive approach after robotic total gastrectomy: technical details and short-term outcomes [J]. World Journal of Gastroenterology, 2017, 23(23): 4293-4302. 

[17] Salvador-Rosés H, Escartín A, Muriel P, et al. Robotic versus open approach in total gastrectomy for gastric cancer: a comparative single-center study of perioperative outcomes[J]. J Robot Surg, 2023, 17(4): 1735-1741. 

[18] 刘江 , 王刚 , 冯啸波 , 等 . 完全机器人手工缝合消化道重建技术 在全胃切除术中的应用 [J]. 机器人外科学杂志 ( 中英文 ), 2021, 2(3): 151-161. 

[19] 中国医师协会外科医师分会上消化道外科学组 , 中华医学会外 科学分会胃肠外科学组 , 中国研究型医院学会消化道肿瘤专业 委员会 , 等 . 机器人胃癌切除术后完全腔内消化道重建中国专 家共识 (2021 版 )[J]. 中华胃肠外科杂志 , 2021, 24(8): 647-652.