机器人与开腹手术治疗肝内胆管细胞癌患者近期疗效研究*

目的 比较机器人与传统开腹手术行肝叶切除术治疗肝内胆管细胞癌(ICC)患者的安全性和短期疗效。方法 2019年1月～2020年12月我院诊治的ICC患者27例,其中9例接受机器人手术,18例接受传统开腹肿瘤根治术,比较两组手术情况。结果 两组均完成肿瘤根治术;机器人组和开腹组患者手术时间【(198±32)分对(215±74)分】、术中出血量【200(100,250) ml对(275(200,300)ml】和术中输血次数(0次对2次)均无统计学差异(P>0.05);机器人组和开腹组患者肿瘤直径【4.0(2.5,5.5) cm 对6.3(3.9,6.5) cm】、R0切除率(100.0%对88.0%)和淋巴结转移率(44.4%对38.9%)比较,差异无统计学意义(P>0.05);机器人组术后卧床时间和住院日分别为2(1,2.5)d和7(4,8)d,显著短于开腹组【分别为3(1.8,3.5)d和11(8,12)d,P<0.05】,机器人组住院费用为11.3(9.1,13.5)万,与开腹组的10.1(8.8,11.5)万比,无统计学差异(P>0.05);两组术后并发症发生率为11.1%和27.8%,无统计学差异(P>0.05)。结论 开展机器人肿瘤根治术治疗ICC患者安全,术后恢复快。

Robotic hepatectomy in treatment of patients with intrahepatic cholangiocarcinoma: A preliminary study

Objective The purpose of this study was to compare the safety of robotic and laparotomy hepatectomy in dealing with patients with intrahepatic cholangiocarcinoma (ICC). Methods A total of 27 patients with ICC were enrolled in the Hepatobiliary and Pancreatic Surgery Center, Drum Tower Hospital between January 2019 and December 2020, and 9 patients received robotic hepatectomy and 18 open surgery. Results The radical surgery was finished in all patients in both groups; there were no significant differences respect to operation time [(198±32)min vs. (215±74) min], intraoperative blood loss [200 (100,250) ml vs.(275(200,300) ml] and intraoperative blood transfusion (0.0% vs. 11.1%, all P>0.05); there were no significant differences as respect to maximal tumor diameter [4.0 (2.5,5.5) cm vs. 6.3 (3.9, 6.5) cm], R0 resection rate (100.0% vs. 88.0%) and lymph node metastasis rate (44.4% vs. 38.9%) between the two groups (P>0.05); the postoperative bed time and hospitalization stay in patients receiving robotic surgery were 2(1, 2.5)d and 7(4, 8)d, significantly shorter than [3(1.8, 3.5)d and 11(8, 12)d, respectively, P<0.05] in patients receiving open surgery, and there was no significant difference respect to medical costs [113.0 (91.0, 135.0) thousands in robotic vs. 101.0(880.0, 115.0) thousands in open surgery, P>0.05); there was no significant difference in post-operational complications (11.1% vs. 27.8%) in the two groups (P>0.05). Conclusion The robotic hepatectomy in dealing with patients with ICC in safe, with a rapid postoperative recovery.