目的：初步探讨两种腔内吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的安全性及优 缺点。方法：回顾性分析 2019 年 11 月—2021 年 9 月在南京中医药大学附属医院普外科行达芬奇机器人辅助远端胃 癌根治术的 64 例患者的临床资料。根据吻合方法不同将其分为手工缝合吻合组（n=35）和器械辅助吻合组（n=29）。 收集患者围手术期的临床资料，对比两种吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的优缺点。结 果：64 例患者均顺利完成手术，所有患者均在机器人镜下完成腔内消化道重建，无中转开腹。两组患者在手术时间、 术中出血量、术后首次肛门排气时间、术后首次下床活动时间、术后首次进食流质时间及术后住院时间方面无明显 统计学差异。器械辅助吻合组胃肠吻合时间较手工缝合吻合组短，而手工缝合吻合组的吻合耗材费用较低，差异具 有统计学意义。两组患者术后均恢复良好，无并发症发生。结论：两种腔内吻合方法在机器人辅助远端胃切除术后 毕Ⅱ式消化道重建中的应用都是安全可行的，器械辅助吻合的时间更短，手工缝合吻合的费用更低。

Objective: To explore the safety and competitive strengths of two intracorporeal anastomosis methods in Billroth II reconstruction after robot-assisted distal gastrectomy. Methods: Clinical data of 64 patients with gastric cancer who underwent intracorporeal anastomosis after Da Vinci robot-assisted distal gastrectomy in the Affiliated Hospital of Nanjing University of Chinese Medicine from November 2019 to September 2021 were retrospectively reviewed. The patients were divided into the manual anastomosis group and the instrument-assisted anastomosis group according to different anastomosis methods. Perioperative data of patients in the two groups were collected, and the advantages and disadvantages were compared between the two methods. Results: All the 64 cases of robot-assisted distal gastrectomy and Billroth II reconstruction were successfully completed without conversion to open surgery. The operative time, blood loss, time to first anal exhaust and off-bed activity after surgery, first time to fluid food intake, length of hospital stay were not statistically different between the two groups (P>0.05). However, the mean anastomosis time was shorter in the instrument-assisted anastomosis group than that in the manual anastomosis group, while the manual anastomosis group had a lower cost on anastomotic consumables. Both groups of patients recovered well after surgery, and no complications was found. Conclusion: These findings suggest that two intracorporeal anastomosis methods could be safe and feasible to do Billroth II reconstruction in patients undergoing robot-assisted distal gastrectomy. Instrument-assisted anastomosis has a shorter anastomosis time, while manual anastomosis has a lower anastomosis cost.

收稿日期：2023-10-11  录用日期：2024-01-18 

Received Date: 2023-10-11  Accepted Date: 2024-01-18 

基金项目：江苏省医学重点学科建设项目（ZDXK202251） 

Foundation Item: Key Medical Discipline Construction Project of Jiangsu Province(ZDXK202251) 

通讯作者：刘江，Email：doctorliujiang@126.com 

Corresponding Author: LIU Jiang, Email: doctorliujiang@126.com 

引用格式：邓正明，江志伟，王刚，等 . 两种腔内吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的应用比较 [J]. 机器 人外科学杂志（中英文），2024，5（5）：892-897. 

Citation: DENG Z M, JIANG Z W, WANG G, et al. Comparative study of two intracorporeal anastomosis methods in Billroth II reconstruction after robot-assisted distal gastrectomy [J]. Chinese Journal of Robotic Surgery, 2024, 5(5): 892-897.

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