机器人与开腹手术治疗肝内胆管细胞癌患者近期疗效研究  

Robotic hepatectomy in treatment of patients with intrahepatic cholangiocarcinoma:A preliminary study

作　　者：马虎成[1] 任昊桢[1] 汤宁[1] 王帅[1] 张玉衡 施晓雷[1] Ma Hucheng;Ren Haozhen;Tang Ning(Pancreatic Surgery,Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属鼓楼医院肝胆胰中心,南京市210008

出　　处：《实用肝脏病杂志》2022年第3期423-426,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:81902957);十三五南京市卫生青年人才培养工程基金资助项目(编号:QRX17130)。

摘　　要：目的比较机器人与传统开腹手术行肝叶切除术治疗肝内胆管细胞癌(ICC)患者的安全性和短期疗效。方法2019年1月~2020年12月我院诊治的ICC患者27例,其中9例接受机器人手术,18例接受传统开腹肿瘤根治术,比较两组手术情况。结果两组均完成肿瘤根治术;机器人组和开腹组患者手术时间【(198±32)分对(215±74)分】、术中出血量【200(100,250)ml对275(200,300)ml】和术中输血次数(0次对2次)均无统计学差异(P>0.05);机器人组和开腹组患者肿瘤直径【4.0(2.5,5.5)cm对6.3(3.9,6.5)cm】、R0切除率(100.0%对88.0%)和淋巴结转移率(44.4%对38.9%)比较,差异无统计学意义(P>0.05);机器人组术后卧床时间和住院日分别为2(1,2.5)d和7(4,8)d,显著短于开腹组【分别为3(1.8,3.5)d和11(8,12)d,P<0.05】,机器人组住院费用为11.3(9.1,13.5)万,与开腹组的10.1(8.8,11.5)万比,无统计学差异(P>0.05);两组术后并发症发生率为11.1%和27.8%,无统计学差异(P>0.05)。结论开展机器人肿瘤根治术治疗ICC患者安全,术后恢复快。Objective The purpose of this study was to compare the safety of robotic and laparotomy hepatectomy in dealing with patients with intrahepatic cholangiocarcinoma(ICC).Methods A total of 27 patients with ICC were enrolled in the Hepatobiliary and Pancreatic Surgery Center,Drum Tower Hospital between January 2019 and December 2020,and 9 patients received robotic hepatectomy and 18 open surgery.Results The radical surgery was finished in all patients in both groups;there were no significant differences respect to operation time[(198±32)min vs.(215±74)min],intraoperative blood loss[200(100,250)ml vs.275(200,300)ml]and intraoperative blood transfusion(0.0%vs.11.1%,all P>0.05);there were no significant differences as respect to maximal tumor diameter[4.0(2.5,5.5)cm vs.6.3(3.9,6.5)cm],R0 resection rate(100.0%vs.88.0%)and lymph node metastasis rate(44.4%vs.38.9%)between the two groups(P>0.05);the postoperative bed time and hospitalization stay in patients receiving robotic surgery were 2(1,2.5)d and 7(4,8)d,significantly shorter than[3(1.8,3.5)d and 11(8,12)d,respectively,P<0.05]in patients receiving open surgery,and there was no significant difference respect to medical costs[113.0(91.0,135.0)thousands in robotic vs.101.0(880.0,115.0)thousands in open surgery,P>0.05];there was no significant difference in post-operational complications(11.1%vs.27.8%)in the two groups(P>0.05).Conclusion The robotic hepatectomy in dealing with patients with ICC in safe,with a rapid postoperative recovery.

关 键 词：肝内胆管细胞癌 肝叶切除术 机器人 外科治疗 

分 类 号：R735.8[医药卫生—肿瘤]