Wang X Y, Chang W J, Xu J M
Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2020 Dec 25;23(12):1139-1143. doi: 10.3760/cma.j.cn.441530-20200407-00188.
Surgical resection remains the only curative therapy for colorectal adenocarcinoma and liver metastasis. Synchronous robotic resection for colorectal liver metastasis (CRLM) offers the advantage of avoiding double surgical stress, while providing the benefits of small incision, quicker recovery, shorter hospital stay and faster postoperative adjuvant therapy. Compared with the laparoscopic approach, robotic approach is mostly suitable for rectal cancer liver metastasis, which is associated with low conversion rate, good nerve protection, high success rate for major hepatectomy and resection of difficult segments. Appropriately selected patients, multidisciplinary cooperation and skillful robotic surgeons are the key to success. Current data have demonstrated the feasibility and safety of synchronous robotic resection for CRLM. With the coming randomized controlled trial data and evolution of robotic surgical system, the future of synchronous robotic resection for colorectal liver metastasis is promising.
手术切除仍然是结直肠癌伴肝转移的唯一治愈性疗法。结直肠癌肝转移（CRLM）的同期机器人切除术具有避免双重手术应激的优势，同时具备切口小、恢复快、住院时间短及术后辅助治疗启动快等优点。与腹腔镜手术相比，机器人手术更适合于直肠癌肝转移，其具有较低的中转率、良好的神经保护、肝大部切除术及困难肝段切除的高成功率。选择合适的患者、多学科协作以及技术娴熟的机器人手术医生是成功的关键。目前的数据已证实CRLM同期机器人切除术的可行性和安全性。随着即将到来的随机对照试验数据以及机器人手术系统的发展，结直肠癌肝转移同期机器人切除术的前景十分广阔。
