论文部分内容阅读
目的:总结机器人辅助腹腔镜肝切除的初步经验。方法 :回顾性分析我院2010年1月至2016年1月连续60例达芬奇机器人辅助腹腔镜肝切除术病人的临床资料。结果:60例中57例完成机器人辅助腹腔镜肝切除术,3例中转开腹,中转率为5.0%。平均手术时间(353±121)min,术中失血量(390±287)m L,术中输血率11.7%,术后并发症发生率25.0%(15例),其中3b级以上发生率3.3%,术后住院时间(9.1±3.3)d。22例肝胆管结石病病人术中结石清除率95.5%,1例残余结石病人术后经T管窦道胆道镜取出,最终结石清除率100%。围手术期无死亡病例。随访时间(18.8±12.0)(2~50)个月,24例恶性肿瘤中7例复发,4例死亡,3例带瘤生存,其余17例健康生存,无复发转移。22例肝胆管结石病人,其中2例复发,均接受再次手术治疗,2例出现胆管炎症状,接受药物治疗后好转。结论:针对选择性病例,机器人辅助腹腔镜肝切除术安全可行、疗效确切,并具有微创手术优势。
OBJECTIVE: To summarize the preliminary experience of robot assisted laparoscopic liver resection. Methods: A retrospective analysis of our hospital from January 2010 to January 2016 consecutive 60 cases of da Vinci robotic assisted laparoscopic hepatectomy in patients with clinical data. Results: Fifty-seven of 60 patients underwent robotic-assisted laparoscopic hepatectomy and 3 of them underwent laparotomy. The conversion rate was 5.0%. The average operative time was 353 ± 121 min, blood loss was (390 ± 287) m L during surgery, blood transfusion rate was 11.7% and postoperative complication rate was 25.0% (15 cases) , Postoperative hospital stay (9.1 ± 3.3) d. Twenty-two patients with intrahepatic stone gallbladder disease had a clear stone clearance rate of 95.5%. One patient with residual stone was removed by choledoch choledochoscope after operation. The final stone clearance rate was 100%. Perioperative death cases. During the follow-up (18.8 ± 12.0) months (2 ~ 50) months, 7 of 24 malignant tumors recurred, 4 died, 3 survived, and the remaining 17 survived without recurrence. 22 cases of hepatolithiasis patients, including 2 cases of recurrence, were underwent reoperation, 2 cases of cholangitis symptoms, after receiving medication improved. Conclusion: For selective cases, robotic-assisted laparoscopic hepatectomy is safe, feasible and effective and has the advantage of minimally invasive surgery.