中国实用外科杂志

中国实用外科杂志

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机器人辅助腹腔镜肝切除术142例报告

王晓颖，高    强，端    猛，丁振斌，朱晓东，彭远飞，周    俭，樊    嘉   

  1. 复旦大学附属中山医院肝外科，上海 200032
  • 出版日期:2017-05-01 发布日期:2017-04-28

  • Online:2017-05-01 Published:2017-04-28

摘要：

目的    评估机器人辅助腹腔镜肝切除术的临床疗效。方法    回顾性分析复旦大学附属中山医院2010年3月至2016年12月行机器人辅助腹腔镜肝切除术的142例病人的临床资料。结果    原发性肝癌62例，结直肠癌肝转移55例，肝门部胆管癌1例，肝良性病变23例，活体肝移植供体1例。≥3个肝段的大范围肝切除占36.6%，<3个肝段的部分肝切除占63.4%。无中转开腹手术。出血量（119.0±121.8）mL，输血率1.4%。R0切除率100%，围手术期并发症发生率（> Grade Ⅲ）2.8%，病死率为0。术后住院（5.5±2.2）d。原发性肝癌病人术后1、3、5年总体存活率为97.8%、90.8%、76.2%，结直肠癌肝转移病人术后1、2年总体存活率为97.8%、97.8%。结论    对于适宜病例，机器人辅助腹腔镜肝切除治疗肝肿瘤安全可靠，近期及远期疗效良好。

关键词: 机器人手术系统, 腹腔镜, 肝切除术, 肝肿瘤

Abstract:

Outcomes of robot-assisted laparoscopic liver resection: A report of 142 cases        WANG Xiao-ying, GAO Qiang, DING Zhen-bin, et al. Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Corresponding author:FAN Jia, E-mail:jiafan@zs-hospital.sh.cn
Abstract    Objective    To analyze the perioperative and oncological outcomes of robot-assisted laparoscopic liver resection. Methods    The clinical data of 142 cases of liver neoplasm underwent robot-assisted laparoscopic liver resection between March, 2010 and December, 2016 at Zhongshan Hospital, Fudan University were analyzed retrospectively. Results    There were 62 cases of primary liver cancer, 55 cases of liver metastasis of colorectal cancer (CRLM), 1 case of hilar cholangiocarcinoma, 23 cases of benign liver disease, and 1 case of living donor hepatectomy. Liver resection was the major resection (≥3 segments) in 52 cases (36.6%) and was the minor liver resection(<3 segments) in 90  cases (63.4%). Conversion rate is 0. Operative blood loss was（119.0±121.8）mL, and 2 cases (1.4%) received blood transfusion. The R0 resection rate was 100%. The perioperative complication incidence （> grade Ⅲ） and mortality were 1.4% and 0, respectively. The hospital stay was（5.5±2.2）days. The 1, 3, 5-year overall survival rates for primary liver cancer were 97.8%、90.8%76.2%, respectively. The 1, 2-year overall survival rates for CRLM were 97.8% and 97.8%, respectively. Conclusion    Robot-assisted laparoscopic liver resection for liver neoplasm is safe and feasible in selected patients, with favorable operative outcome and long-term oncologic results.

Key words: robot surgical system, laparoscopy, hepatectomy, liver neoplasms