3D 腹腔镜与机器人辅助肝切除术治疗肝细胞癌的疗效比较：一项多中心研究。
Outcomes after 3D laparoscopic and robotic liver resection for hepatocellular carcinoma: a multicenter comparative study.
机构信息
Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France.
Sorbonne Université, Paris, France.
出版信息
Surg Endosc. 2021 Jul;35(7):3258-3266. doi: 10.1007/s00464-020-07762-7. Epub 2020 Jul 2.
BACKGROUND
The recent development of 3D vision in laparoscopic and robotic surgical systems raises the question of whether these two procedures are equivalent. The aim of this study was to evaluate the surgical and long-term oncological outcomes of 3D laparoscopic (3D-LLR) and robotic liver resection (RLR) for hepatocellular carcinoma (HCC).
METHODS
The data for operative time, morbidity, margins, and survival were reviewed for 3D-LLR and compared with RLR.
RESULTS
From 2011 to 2017, 93 patients with HCC, including 58 (62%) with cirrhosis, underwent 3D-LLR [49 (53%)] or RLR [44 (47%)]. No difference was observed in operative time (269 vs. 252 min; p = 0.52), overall (27% vs. RLR: 16%; p = 0.49) and severe morbidity (4% vs. 2%; p = 0.77) or in the surgical margin width (9 vs. 11 mm; p = 0.30) between the 3D-LLR and RLR groups. The 3-year overall and recurrence-free survival rates after 3D-LLR and RLR were 82% and 24% and 91% (p = 0.16) and 48% (p = 0.18), respectively.
CONCLUSIONS
The 3D-LLR and RLR systems provide comparable surgical margins with similar short- and long-term oncological outcomes.
背景
腹腔镜和机器人手术系统中 3D 视觉技术的最新发展提出了这样一个问题，即这两种手术是否等效。本研究旨在评估 3D 腹腔镜（3D-LLR）和机器人肝切除术（RLR）治疗肝细胞癌（HCC）的手术和长期肿瘤学结果。
方法
对 3D-LLR 的手术时间、发病率、切缘和生存数据进行了回顾，并与 RLR 进行了比较。
结果
2011 年至 2017 年间，93 例 HCC 患者接受了 3D-LLR [49 例（53%）]或 RLR [44 例（47%）]。两组患者的手术时间（269 分钟与 252 分钟；p=0.52）、总发病率（27%与 RLR：16%；p=0.49）和严重发病率（4%与 2%；p=0.77）或手术切缘宽度（9 毫米与 11 毫米；p=0.30）均无差异。3D-LLR 和 RLR 组患者的 3 年总生存率和无复发生存率分别为 82%和 24%和 91%（p=0.16）和 48%（p=0.18）。
结论
3D-LLR 和 RLR 系统提供了可比的手术切缘，具有相似的短期和长期肿瘤学结果。
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