机器人外科学杂志（中英文）2025，Vol.6Issue(10)：1646-1651,6.DOI:10.12180/j.issn.2096-7721.2025.10.004
机器人辅助手术在超低位直肠癌患者中的应用
Application of robot-assisted surgery in patients with ultra-low rectal cancer
摘要
Abstract
Objective:To investigate the comprehensive effects of robot-assisted function-preserving surgery for ultra-low rectal cancer on positive surgical margin rate,anastomotic leakage incidence,and postoperative bowel and urinary function.Methods:100 patients who underwent function-preserving surgery for ultra-low rectal cancer from March 2021 to March 2024 were enrolled and randomly divided into the control group(n=45,receiving traditional open surgery)and the experimental group(n=55,receiving robot-assisted surgery).Anal recovery-related indicators,serum markers,bowel function,urinary function,positive surgical margin rate,and incidence of anastomotic leakage were compared between the two groups.Results:Compared with the control group,the experimental group had significantly lower intraoperative blood loss,shorter operative time and length of hospital stay,and earlier time to first flatus,first defecation,and anal autonomous control recovery(P<0.05).Postoperatively,interleukin-6(IL-6)and C-reactive protein(CRP)levels increased,while carbohydrate antigen 19-9(CA19-9)and carcinoembryonic antigen(CEA)levels decreased in both groups,while lower IL-6,CRP,CA19-9,and CEA levels were found in the experimental group than those in the control group(P<0.05).The experimental group also had lower positive surgical margin rate and incidence of anastomotic leakage(P<0.05).At 1 month postoperatively,Wexner scores increased in both groups but decreased at 3 and 6 months after surgery,with the experimental group consistently scoring lower(P<0.05).At 1 month postoperatively,the maximum urinary flow rate decreased in both groups of patients.However,at 3 and 6 months postoperatively,the maximum urinary flow rate increased in both groups.Furthermore,the experimental group showed significantly higher maximum urinary flow rates than the control group at all assessed postoperative time points(P<0.05).Conclusion:Robot-assisted function-preserving surgery for ultra-low rectal cancer is less traumatic,it can effectively promote postoperative anal recovery,reduce early inflammatory responses,lower serum tumor marker levels,decrease positive surgical margin rate and anastomotic leakage rate,and improve bowel and urinary function recovery.关键词
机器人辅助手术/超低位直肠癌/吻合口漏/排便功能/排尿功能Key words
Robot-assisted Surgery/Ultra-low Rectal Cancer/Anastomotic Leakage/Bowel Function/Urinary Function分类
临床医学引用本文复制引用
李严,陈望旺,章艺..机器人辅助手术在超低位直肠癌患者中的应用[J].机器人外科学杂志（中英文）,2025,6(10):1646-1651,6.基金项目
六大人才高峰省级D类资助项目(2023059)Provincial D-class Funding Project for the Six Major Talent Peaks(2023059) （2023059）
