【摘要】 目的:探讨机器人McKeown食管癌切除术的临床应用,评估其安全性和短期疗效。方法:回顾性分析2017年6月～2019年12月单一手术组行机器人McKeown食管癌切除术121例患者的临床资料和短期临床结果。结果:121例患者中位年龄60(34～77)岁,其中男100例,女21例,32例行新辅助治疗。平均手术时间(320.2±43.1)min,失血量(197.4±33.4)ml,每例淋巴结清扫23(5～71)个。术后病理证实鳞癌患者109例;32例行新辅助治疗的患者中,9例获得病理完全缓解(28.1%)。74例左喉返神经旁淋巴结清扫数目为4(1～13)个,转移率为21.6%(16/74);101例右喉返神经旁淋巴结清扫数目为3(1～13)个,转移率为18.8%(19/101)。术后总体并发症发生率为34.7%(42/121),包括声嘶17例(14.0%)、肺炎13例(10.7%)、吻合口瘘9例(7.4%)、胸腔积液4例(3.3%)、切口感染2例(1.7%)、乳糜胸1例(0.8%)、其他并发症共8例;术后9例患者入住ICU时间5(1～21)d。全组患者无死亡病例,术后中位住院时间14(13～64)d。结论:机器人McKeown食管癌切除术应用于食管癌安全可行,可获得较满意的短期疗效。更多还原

【Abstract】 Objective: To investigate the clinical application of robot-assisted McKeown esophagectomy(RAME) and evaluate its safety and short-term outcomes. Methods: The clinical data and short-term outcomes of 121 patients underwent RAME from June 2017 to December 2019 in a single-operation group were retrospectively analyzed. Results: The median age of 121 patients was 60(34～77) years old, including 100 males and 21 females, of which 32 patients received neoadjuvant therapy. The average operation time was(320.2±43.1)min, the blood loss was(197.4±33.4)ml and the median number of dissected lymph node was 23(5～71). 109 patients were confirmed with squamous cell carcinoma by postoperative pathology, and 9 patients achieved pathological complete remission among 32 patients whom underwent neoadjuvant therapy(9/32, 28.1%). 74 cases underwent lymph node dissection at left laryngeal recurrent nerve(LRN) and the median number of dissected lymph node was 4(1～13) with metastasis rate of 21.6%(16/74). 101 cases underwent lymph node dissection at right LRN and the median number of dissected lymph node was 3(1～13) with metastasis rate of 18.8%(19/101). The overall incidence of postoperative complication was 34.7%(42/121), including 17 cases of hoarseness, 13 cases of pneumonia, 9 cases of anastomotic leakages, 4 cases of pleural effusion, 2 cases of incision infection, 1 case of chylothorax, and 8 cases of other complications. Nine patients were admitted to the ICU after surgery, and the median ICU stay was 5(1～21) d. No perioperative death was found, and the median postoperative hospital stay was 14(13～64) d. Conclusion: RAME is safe and feasible to treat esophageal cancer, which can achieve a satisfactory short-term outcomes.更多还原