目的    探讨达芬奇机器人下经腹直肠癌根治术经阴道或肛门拖出标本的安全性及有效性。方法    回顾性分析2012年2月至2013年9月南京军区南京总医院行机器人经腹直肠癌切除术并经阴道或肛门拖出标本的21例病人临床资料。结果    21例病人中19例经肛门拖出手术标本，2例经阴道拖出。病人平均年龄（62.5±7.8）岁。所有病人均顺利完成手术，无一例中转开腹。手术平均时间（173.6±27.1）min，术中平均出血量（38.7±11.2）mL，标本获取淋巴结平均数目为（16.0±1.8）枚，标本上下切缘均为阴性，术后肛门首次排气时间（1.9±0.4）d，术后平均住院时间（4.2±1.3）d。结论    机器人行经腹直肠癌切除术经阴道或肛门拖出标本安全可行，具有良好的可操作性及实用性。

Trans-natural orifice transuminal specimen extraction in robotic rectal cancer surgery: An analysis of 21 patients        RUAN Hu，LIU Jiang，ZHAO Kun，et al. Department of General Surgery，Affiliated Jinlin Hospital of Nanjing University Medicine College，Nanjing 210002，China
Corresponding author：JIANC Zhi-wei，E-mail：surgery34@163.com
Abstract    Objective    To discuss the safety and feasibility of transanal or vaginal specimen extraction in robotic rectal cancer surgery．Methods    The clinical data of 21 patients who underwent robotic rectal cancer resection with transanal or vaginal specimen extraction from February 2012 to September 2013 in Affiliated Jinlin Hospital of Nanjing University Medicine College were  analyzed retrospectively．Results    There were 21 patients with a mean age of（62.5±7.8）years old，19 of them with transanal specimen extraction，others with vaginal specimen extraction. All the cases underwent robotic surgery successfully with no conversion．The average operative time was （173.6±27.1） min with a mean intraoperative blood loss of （38.7±11.2）mL．The mean number of lymph node harvested was （16.0±1.8）．All the resection margins were negative．The first time to flatus was（1.9±0.4) days postoperatively．The postoperative hospital stay was （4.2±1.3） days．Conclusion    Transanal or vaginal specimen extraction in robotic rectal cancer surgery is safe and feasible with preferable maneuverability and availability.