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机器人肝切除术:障碍与超越。

Robotic liver resection: Hurdles and beyond.

机构信息

Hepato-pancreato-biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

Swiss HPB & Transplant Center Zurich, Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.

出版信息

Int J Surg. 2020 Oct;82S:155-162. doi: 10.1016/j.ijsu.2020.05.070. Epub 2020 Jun 3.

Abstract

Laparoscopy is currently considered the standard of care for certain procedures such as left-lateral sectionectomies and wedge resections of anterior segments. The role of robotic liver surgery is still under debate, especially with regards to oncological outcomes. The purpose of this review is to describe how the field of robotic liver surgery has expanded, and to identify current limitations and future perspectives of the technology. Available evidences suggest that oncologic results after robotic liver resection are comparable to open and laparoscopic approaches for hepatocellular carcinoma and colorectal liver metastases, with identifiable advantages for cirrhotic patients and patients undergoing repeat resections. Excellent outcomes and optimal patient safety can be only achieved with specific hepato-biliary and general minimally invasive training to overcome the learning curve.

摘要

腹腔镜检查目前被认为是某些手术的标准治疗方法,例如左外侧段切除术和前节楔形切除术。机器人肝手术的作用仍存在争议,特别是在肿瘤学结果方面。本综述的目的是描述机器人肝手术领域的扩展,并确定该技术的当前局限性和未来展望。现有证据表明,机器人肝切除术后的肿瘤学结果与肝细胞癌和结直肠癌肝转移的开放和腹腔镜方法相当,对于肝硬化患者和需要重复切除的患者具有明显优势。只有通过专门的肝胆和普通微创培训来克服学习曲线,才能实现出色的结果和最佳的患者安全性。

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