Department of Liver Surgery, the Second XiangYa Hospital of Central South University, Renmin Road 139, Changsha, 410011, Hunan Province, People's Republic of China.
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University, Shuangyong Road 6, Nanning, 530021, Guangxi Province, People's Republic of China.
Updates Surg. 2024 Oct;76(6):2229-2235. doi: 10.1007/s13304-024-01976-3. Epub 2024 Sep 5.
Worldwide use of robotic-assisted hepatectomy has increased dramatically over the past two decades. The role of robotic liver surgery is still controversial, especially with respect to its long-term oncological outcomes in treating early-stage hepatocellular carcinoma (HCC). The Glissonean approach is a fundamental technique for anatomical resection using open and laparoscopic liver surgery. To our knowledge, there have been few reports on purely robotic anatomical segmentectomy 7 for HCC using the Glissonean approach have been described. The present study describes the technical details and surgical outcomes of totally robotic segmentectomy 7 using the Glissonean approach. Fourteen patients with HCC limited to segment 7 underwent segmentectomy 7 from January 2019 through April 2023 in our hospital. The surgical techniques, peri-operative, and oncological outcomes were analyzed. Purely robotic anatomical segmentectomy 7 using the Glissonean approach was safe and feasible with the technology described herein in all of the 14 patients. The peri-operative and oncological outcomes were better and/or comparable with those of other similar hepatic resections using open approach and/or laparoscopic approach. The median follow-up time was 18 months. Intrahepatic recurrence occurred in 2 (14.3%) patient within one year following surgery. The 3-year overall survival rate was 81%. Although technically challenging, the purely robotic segmentectomy 7 could be performed safely and simultaneously with oncological radicality using the Glissonean approach.
在过去的二十年中，全球范围内使用机器人辅助肝切除术的情况急剧增加。机器人肝手术的作用仍存在争议，尤其是在治疗早期肝细胞癌 (HCC) 的长期肿瘤学结果方面。Glisson 入路是开放和腹腔镜肝手术解剖性切除的基本技术。据我们所知，很少有关于使用 Glisson 入路的纯机器人解剖性 7 段切除术治疗 HCC 的报道。本研究描述了使用 Glisson 入路的完全机器人 7 段切除术的技术细节和手术结果。2019 年 1 月至 2023 年 4 月，我院对 14 例局限于 7 段的 HCC 患者进行了 7 段切除术。分析了手术技术、围手术期和肿瘤学结果。在所有 14 例患者中，使用 Glisson 入路的纯机器人解剖性 7 段切除术是安全可行的，符合本文所述的技术要求。围手术期和肿瘤学结果优于或与开放和/或腹腔镜入路的其他类似肝切除术相当。中位随访时间为 18 个月。术后 1 年内有 2 例（14.3%）患者发生肝内复发。3 年总生存率为 81%。虽然技术上具有挑战性，但使用 Glisson 入路的纯机器人 7 段切除术可以安全地同时进行，具有肿瘤根治性。
