摘要目的:探讨达芬奇机器人经肛微创手术（R-TAMIS）治疗直肠肿瘤的疗效。方法:回顾性选取2021年1月至2024年1月解放军总医院第一医学中心行R-TAMIS并定期随访的直肠肿瘤患者，分别于术后1、2、4周随访，随后每3个月随访1次，随访时间截至2024年1月20日。观察患者围手术期情况、术后组织病理学结果、随访情况。结果:共纳入17例患者，男10例，女7例，年龄为35~80（59±13）岁，11例患者采用达芬奇 ?Si机器人完成手术，6例患者采用达芬奇 ?Xi机器人完成手术，手术切除肿瘤距肛缘的高度［ M（ Q1， Q3）］为3.5（3.0，3.8）cm；总手术时间为55.0（50.0，55.0）min，平台安装时间为32.5（30.0，35.0）min，手术操作时间为22.5（20.0，27.5）min；术中出血量为9.2（5.0，10.0）ml；术后住院天数为3.2（3.0，3.8）d；住院费用为（29 447±4 765）元。有2例接受新辅助放化疗后获得临床完全缓解的患者在术后1周出现切口裂开，直肠腔内冲洗治疗4周后痊愈。所有的手术标本完整，切缘均为阴性。共随访44（31，73）周，无局部复发及远处转移。 结论:达芬奇机器人经肛微创局部切除术可能是一种治疗直肠肿瘤的安全、可行的方法。

abstractsObjective:To investigate the efficacy of Da Vinci robotic transanal minimally invasive surgery (R-TAMIS) for rectal neoplasms.Methods:The patients of rectal neoplasms who underwent R-TAMIS and were regularly followed up at the First Medical Center of Chinese PLA General Hospital from January 2021 to January 2024 were retropectively selected. Follow-up visits were conducted at 1, 2, and 4 weeks postoperatively, and then every 3 months until January 20, 2024. The perioperative situation, postoperative histopathological results, and follow-up status of the patients were observed.Results:A total of 17 patients were included, including 10 males and 7 females, aged 35-80 (59±13) years. Eleven patients underwent surgery using the da Vinci? Si robot, while 6 patients underwent surgery using the da Vinci? Xi robot. The height of the resected tumor from the anal verge [ M ( Q1,Q3)] was 3.5 (3.0, 3.8) cm. The total operative time was 55.0 (50.0, 55.0) minutes, the platform installation time was 32.5 (30.0, 35.0) minutes. The actual surgical operation time was 22.5 (20.0, 27.5) minutes. Intraoperative blood loss was 9.2 (5.0, 10.0) ml. The postoperative hospital stay was 3.2 (3.0, 3.8) days. The total treatment cost was (29 447±4 765) yuan. Two patients who achieved clinical complete remission after neoadjuvant chemoradiotherapy experienced incision dehiscence one week postoperatively, which was resolved after four weeks of rectal irrigation therapy. All surgical specimens were intact, and all resection margins were negative. A total of 44(31,73) weeks were followed up, without local recurrence or distant metastasis. Conclusion:Da Vinci robotic transanal minimally invasive local resection may be a safe and feasible treatment option for rectal neoplasms.