Lee Kit-Fai, Cheung Yue-Sun, Chong Charing C N, Wong John, Fong Anthony K W, Lai Paul B S
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
ANZ J Surg. 2016 Mar;86(3):122-6. doi: 10.1111/ans.13339. Epub 2015 Sep 30.
Both laparoscopic and robotic hepatectomy have been adopted in our centre for selected patients with benign or malignant liver diseases. This article reports the perioperative outcomes of these two approaches and tries to determine any difference between them.
A retrospective review of prospectively collected data was performed for all patients who underwent laparoscopic hepatectomy (LH) and robotic hepatectomy (RH) in our institute. The perioperative results were reported and compared. In order to standardise the type of liver resection performed, a subgroup analysis was made for laparoscopic left lateral sectionectomy (LS) and robotic left lateral sectionectomy (RS).
Sixty-six LH and 70 RH were performed between November 2003 and January 2015. The two groups were comparable in demographic data and disease characteristics except more patient with recurrent pyogenic cholangitis (RPC) occurred in RH group. More major hepatectomies were performed in RH (20.0% versus 3.0%, P = 0.002). There was no mortality. No difference was noted in morbidity (LH 4.5%, RH 11.4%), conversion rate (LH 12.1%, RH 5.7%), median blood loss (both 100 mL) and median length of post-operative hospital stay (both 5 days) but operative time was longer in RH (251.5 min versus 215 min, P = 0.008). There were 29 LS and 38 RS, no difference was noted in all perioperative outcomes between the two groups.
Both laparoscopic and robotic hepatectomy are safe and their perioperative outcomes are comparable and favourable.
在我们中心，对于选定的患有良性或恶性肝脏疾病的患者，已采用腹腔镜肝切除术和机器人辅助肝切除术。本文报告了这两种手术方式的围手术期结果，并试图确定它们之间的差异。
对我院所有接受腹腔镜肝切除术（LH）和机器人辅助肝切除术（RH）的患者进行了前瞻性收集数据的回顾性分析。报告并比较围手术期结果。为了标准化所进行的肝切除类型，对腹腔镜左外侧段切除术（LS）和机器人辅助左外侧段切除术（RS）进行了亚组分析。
2003年11月至2015年1月期间共进行了66例LH和70例RH。除RH组复发性化脓性胆管炎（RPC）患者更多外，两组在人口统计学数据和疾病特征方面具有可比性。RH组进行的大肝切除术更多（20.0%对3.0%，P = 0.002）。无死亡病例。在发病率（LH 4.5%，RH 11.4%）、转化率（LH 12.1%，RH 5.7%）、中位失血量（均为100 mL）和术后住院中位时间（均为5天）方面未发现差异，但RH组手术时间更长（251.5分钟对215分钟，P = 0.008）。有29例LS和38例RS，两组在所有围手术期结果方面均未发现差异。
腹腔镜肝切除术和机器人辅助肝切除术均安全，其围手术期结果具有可比性且良好。
