Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
J Robot Surg. 2022 Apr;16(2):401-407. doi: 10.1007/s11701-021-01257-w. Epub 2021 May 25.
Although open resections have been the most prevalent method of hepatectomies in the United States, laparoscopic and robotic methods of liver resection have since gained significant traction. Given the augmenting role of minimally invasive techniques in liver resection, a study that explores and analyzes the surgical outcomes of the approaches mentioned above to liver resection on a national basis is warranted. A retrospective analysis was performed in this study using the 2016-2018 Nationwide Readmissions Database (NRD). Patients who underwent liver resections via one of the following methods were selected and grouped: open, laparoscopic, or robotic. Our primary outcome variable of interest was the 45-day readmission rate. 11,186 patients were included in the analysis. The 45-day readmission rate was 13.5%, 12.9%, and 8.7% in the open, laparoscopic, and robotic groups, respectively (p < 0.001). A significantly lower complication rate (7.3%) was seen in the robotic group than its counterparts (11.4% in open vs. 9.1% in the laparoscopic group). Patients undergoing hepatectomies may benefit from the robotic approach given that it is associated with a shorter hospital length of stay and lower readmission rates.
尽管在美国，开放性肝切除术一直是最常见的肝切除术方法，但腹腔镜和机器人肝切除术方法此后也得到了广泛关注。鉴于微创技术在肝切除术中的作用不断增强，有必要对上述肝切除术方法的手术结果进行全国范围内的研究和分析。本研究采用 2016-2018 年全国再入院数据库（NRD）进行回顾性分析。选择并分组了通过以下一种方法进行肝切除术的患者：开放性、腹腔镜或机器人。我们主要关注的结果变量是 45 天再入院率。共有 11186 名患者纳入分析。开放性、腹腔镜和机器人组的 45 天再入院率分别为 13.5%、12.9%和 8.7%（p<0.001）。机器人组的并发症发生率（7.3%）明显低于其他两组（开放性为 11.4%，腹腔镜为 9.1%）。鉴于机器人手术与较短的住院时间和较低的再入院率相关，接受肝切除术的患者可能会受益于机器人手术。
