Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Int J Med Robot. 2020 Apr;16(2):e2087. doi: 10.1002/rcs.2087. Epub 2020 Feb 18.
The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique can induce a greater degree of hypertrophy of the future liver remnant (FLR) in a shorter time compared with other procedures. A robotic approach may reduce the complication rate, increasing the ability to perform classic ALPPS.
We report technical and clinical considerations on the first full robotic ALPPS (stages 1 and 2) for hepatocellular carcinoma (HCC) with portal vein intrahepatic tumor thrombus.
The patient was a 38-year-old man with Milan-out HCC and FLR volume of 19.6%. On postoperative day (POD) 8, FLR increased to 37%; therefore, he underwent completion of ALPPS on POD 10. The postoperative course was uneventful, and the patient was discharged in good general conditions on POD 3.
Robotic ALPPS is safe and feasible for selected patients with initially unresectable HCC or requiring extended resections, with good postoperative outcomes.
与其他手术相比，联合肝脏离断和门静脉结扎的分阶段肝切除术（ALPPS）技术可在更短的时间内使未来肝残留（FLR）更大程度地增生。机器人手术可能会降低并发症发生率，从而提高实施经典 ALPPS 的能力。
我们报告了首例全机器人辅助 ALPPS（第 1 阶段和第 2 阶段）用于伴有门静脉肝内肿瘤血栓的肝细胞癌（HCC）的技术和临床注意事项。
患者为 38 岁男性，患有米兰标准外 HCC，FLR 体积为 19.6%。术后第 8 天，FLR 增加到 37%；因此，他在术后第 10 天接受了 ALPPS 术式的完成手术。术后过程顺利，患者一般情况良好，于术后第 3 天出院。
机器人辅助 ALPPS 对于最初无法切除的 HCC 或需要扩大切除的患者是安全且可行的，具有良好的术后效果。
