引用文本：刘炜, 付海啸, 张轩, 等. 膜解剖理念下达芬奇机器人远端胃癌根治术的临床应用[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(2): 246-254.

作者：刘炜，付海啸，张轩，王凯，刘浩，李腾腾，陈帅伟，张文卓，符炜

单位：徐州医科大学附属医院胃肠外科，江苏 徐州 221000

Authors：Liu Wei, Fu Haixiao, Zhang Xuan, Wang Kai, Liu Hao, Li Tengteng, Chen Shuaiwei, Zhang Wenzhuo, Fu Wei

Unit：Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China

摘要：

目的 评价膜解剖理念下达芬奇机器人远端胃癌根治术的围手术期安全性及短期疗效。方法 选取2022年6月至2025年6月徐州医科大学附属医院胃肠外科收治的98例胃中下部癌患者。所有患者均接受膜解剖理论指导的达芬奇机器人远端胃癌根治术，回顾性分析患者的手术时间、术中出血量、淋巴结清扫数目、术后30 d内并发症发生率及术后住院时间。结果 所有手术均顺利完成，无中转开腹病例。平均手术时间为（240.77±18.85） min，术中出血量为（37.95±12.33） ml。平均淋巴结清扫总数为（30.80±5.66）枚，胰腺上缘区域淋巴结（No.5、7、8a、9、11p、12a组）清扫数目分别为（1.32±0.83）枚、（5.71±1.98）枚、（3.29±1.98）枚、（1.43±0.82）枚、（1.55±0.81）枚、（1.25±0.70）枚。术后平均住院时间为（8.02±0.98） d。术后30 d总体并发症发生率7.1%，其中Clavien-Dindo Ⅰ级3例（3.1%），Ⅱ级4例（4.1%），无Ⅲ级及以上并发症。结论 在膜解剖理论指导下开展达芬奇机器人远端胃癌根治术，有利于术中的淋巴结清扫分离，具有良好的手术安全性和短期疗效。

关键词：膜解剖；远端胃癌根治术；达芬奇机器人手术；临床应用

Abstract：

Objective To evaluate the perioperative safety and short‑term efficacy of da Vinci robot‑assisted distal radical gastrectomy based on the membrane anatomy theory. Method A total of 98 patients with middle or lower gastric cancer admitted to the Department of Gastrointestinal Surgery, the Affiliated Hospital of Xuzhou Medical University between June 2022 and June 2025 were selected. All patients underwent the membrane anatomy‑guided da Vinci robot‑assisted distal radical gastrectomy. Data on operative time, intraoperative blood loss, number of dissected lymph nodes, postoperative 30-day complication rate, and postoperative hospital stay were retrospectively analyzed. Result All operations were successfully completed without conversion to open surgery. The mean operative time was (240.77±18.85) minutes, with an intraoperative blood loss of (37.95±12.33) ml. The mean total number of dissected lymph nodes was (30.80±5.66). The numbers of lymph nodes harvested from the superior border of the pancreas (No.5, 7, 8a, 9, 11p, and 12a) were (1.32±0.83), (5.71±1.98), (3.29±1.98), (1.43±0.82), (1.55±0.81), and (1.25±0.70), respectively. The mean postoperative hospital stay was (8.02±0.98) days. The overall complication rate was 7.1%, including 3 cases (3.1%) of Clavien-Dindo grade Ⅰ and 4 cases (4.1%) of grade Ⅱ, with no grade Ⅲ or higher complications. Conclusion Da Vinci robot‑assisted distal radical gastrectomy guided by the membrane anatomy theory facilitates intraoperative lymph node separation, demonstrating favorable operative safety and short‑term outcomes.

Key words：Membrane anatomy; Distal radical gastrectomy; Da Vinci robotic surgery; Clinical application

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