摘要
目的总结机器人在肝脏血管瘤切除中的应用经验并评估手术的安全性。方法回顾性分析2016年8月至2024年12月在解放军总医院第一医学中心肝胆胰外科医学部行机器人肝血管瘤切除术患者的临床病理资料。根据肿瘤直径将患者分为<10 cm组和≥10 cm组,根据血管瘤个数将患者又分为单发组和多发组。术中应用达芬奇机器人联合术中超声完成血管瘤切除手术。结果129例患者中,男性33例,女性96例,平均年龄48岁。血管瘤平均直径8.6±2.4 cm,其中<10 cm组91例,≥10 cm组38例;单发组94例,多发组35例;全部患者均实施机器人手术,无中转开腹手术。平均手术时间为97(79.5~135.0)min,术中平均出血量为50(20~100)ml,术中输血8例,术后2例发生胆漏,术后平均住院日5 d。不同肿瘤大小组间的平均手术时间、肝门阻断次数、术中平均出血量和术后平均住院日差异有统计学意义(P<0.05);不同肿瘤个数组间的平均手术时间、肝门阻断次数及术中平均出血量差异有统计学意义(P<0.05)。结论机器人用于肝脏血管瘤尤其是位于复杂部位的血管瘤切除术安全、有效。
Objective To summarize the application experience of robotic resection of hepatic hemangioma and evaluate the safety of the surgery.Methods The clinical and pathological data of patients who underwent robotic resection of hepatic hemangioma from Aug.2016 to Dec.2024 was retrospectively analyzed.Patients were divided into<10 cm and≥10 cm groups based on tumor size,and further divided into single and multiple groups based on the number of hemangioma.Da Vinci robot combined with intraoperative ultrasound were used to complete the hepatic hemangioma resection surgery.Results Among the 129 patients,there were 33 males and 96 females with an average age of 48 years.The average diameter of hemangioma was 8.6±2.4 cm,with 91 cases in the<10 cm group and 38 cases in the≥10 cm group and 94 cases in the single lesion group and 35 cases in the multiple lesion group.Robotic resection surgery was completed in all the patients,and there were no patients who were converted to open surgery.The average surgical time was 97(79.5-135.0)min,with an average intraoperative blood loss of 50(20-100)ml.There were 8 cases of intraoperative blood transfusion,2 cases of postoperative bile leakage,and an average hospital stay of 5 days.There were statistically significant differences(P<0.05)in the average surgical time,number of hepatic portal blockades,average intraoperative bleeding,and average postoperative hospital stay among patients with different tumor sizes.There were also statistically significant differences(P<0.05)in the average surgical time,number of hepatic portal blockades,and average intraoperative bleeding among patients with different tumor arrays.Conclusions The application of robotic resection of hepatic hemangioma,especially those located in complex areas,is safe and effective.
作者
沈寒川
刘洋
张航宇
肖朝辉
赵天赐
李朝县
李成刚
Shen Hanchuan;Liu Yang;Zhang Hangyu;Xiao Chaohui;Zhao Tianci;Li Chaoxian;Li Chenggang(Faculty of Hepato-Pancreato-Biliary Surgery,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)
出处
《中华腔镜外科杂志(电子版)》
2025年第2期105-108,共4页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
关键词
肝脏血管瘤
机器人手术
肝切除
Hepatic hemangioma
Robotic surgery
Hepatectomy
作者简介
通信作者:李成刚,Email:lcgang301@126.com。
