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机器人中央肝切除术治疗胆囊癌。微创方法的结果。

Robotic Central Hepatectomy for the Treatment of Gallbladder Carcinoma. Outcomes of Minimally Invasive Approach.

机构信息

4422Digestive Health Institute, AdventHealth Tampa, Tampa, FL, USA.

出版信息

Am Surg. 2022 Mar;88(3):348-351. doi: 10.1177/00031348211047457. Epub 2021 Nov 19.

Abstract

Gallbladder cancer (GBC) is an uncommon but very aggressive malignancy with poor prognosis. Concerns for oncological inferiority related to the technical difficulties in performing laparoscopic portal lymphadenectomy discourage many surgeons to undertake this operation minimally invasively. With wide application of robotic technology to solve limitations of conventional laparoscopy, we describe our initial outcomes of robotic central hepatectomy and portal lymphadenectomy for gallbladder carcinoma in 15 consecutive patients. Data were presented as median (mean ± SD). Patients were 70 (73 ± 10.9) years old with BMI of 26 (26 ± 3.6) kg/m. Tumor size was 3(4 ± 1.9) cm. Operative duration was 222 (237 ± 85.7) minutes and estimated blood loss was 200 (222 ± 135.4) mL. There were no intraoperative complications and complete resection (R0) was obtained in nearly all patients. Postoperative complications were seen in two patients (bile leak (n = 1) and respiratory failure (n = 1)). Length of stay was 3 (4 ± 4.0) days without 30-day mortality. Robotic approach is safe and effective for the treatment of GBC.

摘要

胆囊癌(GBC)是一种罕见但非常侵袭性的恶性肿瘤,预后不良。由于腹腔镜门脉淋巴结清扫术的技术难度较大,许多外科医生担心肿瘤学上的劣势,因此不愿意进行微创手术。随着机器人技术的广泛应用,解决了传统腹腔镜的局限性,我们描述了我们在 15 例连续胆囊癌患者中进行机器人中央肝切除术和门脉淋巴结清扫术的初步结果。数据以中位数(平均值±标准差)表示。患者年龄为 70 岁(73±10.9)岁,BMI 为 26kg/m²(26±3.6kg/m²)。肿瘤大小为 3cm(4±1.9cm)。手术时间为 222 分钟(237±85.7 分钟),估计出血量为 200 毫升(222±135.4 毫升)。术中无并发症,几乎所有患者均获得完全切除(R0)。术后有 2 例患者出现并发症(胆漏 1 例,呼吸衰竭 1 例)。住院时间为 3 天(4±4.0 天),无 30 天死亡率。机器人方法治疗 GBC 是安全有效的。

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