机器人辅助与开放性肝切除术：病例匹配比较

Robotic versus open liver resections: A case-matched comparison.

作者信息

Morel Philippe, Jung Minoa, Cornateanu Sorina, Buehler Leo, Majno Pietro, Toso Christian, Buchs Nicolas C, Rubbia-Brandt Laura, Hagen Monika E

机构信息

Division of Digestive and Transplant Surgery, Department of Surgery, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.

Division of Pathology, University Hospital Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland.

出版信息

Int J Med Robot. 2017 Sep;13(3). doi: 10.1002/rcs.1800. Epub 2017 Jan 6.

DOI:10.1002/rcs.1800

PMID:28058770

Abstract

BACKGROUND

Most hepatic resections are currently performed using an open approach. Robotic surgery might enable the transition of these procedures to minimally invasive surgery.

METHODS

Pre-, peri- and post-operative data of all patients who underwent a liver resection from 2009/2012 to 2001/2015, were collected prospectively. All robotic resection patients were matched 1:1 to patients who underwent open surgery. Pre- and perioperative data, up to 30 days, were analyzed.

RESULTS

Sixteen robotic and open hepatic resections were identified. Fewer complication events and shorter lengths of stay (LOS, 7.9 versus 11 days, P = 0.0603) were observed for robotic resections. Length of stay in the intermediate care unit (IMC) was shorter after the robotic procedure (10 h vs 16.6 h, P = 0.0699). Operating room (OR) time was significantly longer in the robotic resection cohort (352.8 vs 239.6 min, P = 0.0215). All tumor margins were negative.

CONCLUSIONS

This preliminary comparison demonstrates the general feasibility of minor robotic liver resection in selected cases.

摘要

背景

目前大多数肝脏切除术采用开放手术方式。机器人手术可能促使这些手术向微创手术转变。

方法

前瞻性收集2009/2012至2001/2015期间所有接受肝脏切除术患者的术前、术中和术后数据。所有机器人手术切除患者与接受开放手术的患者按1:1配对。分析术前和围手术期长达30天的数据。

结果

共确定了16例机器人手术和开放手术肝脏切除术。机器人手术切除的并发症事件较少，住院时间较短（住院时间分别为7.9天和11天，P = 0.0603）。机器人手术后在中间护理病房（IMC）的住院时间较短（10小时对16.6小时，P = 0.0699）。机器人手术切除组的手术室（OR）时间明显更长（352.8分钟对239.6分钟，P = 0.0215）。所有肿瘤切缘均为阴性。