Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study.
Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study.
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DOI：
10.1245/s10434-018-6629-9
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发表时间：
2018-09
影响因子：
3.7
通讯作者：
Tsung A
中科院分区：
文献类型：
--
作者：
Khan S;Beard RE;Kingham PT;Fong Y;Boerner T;Martinie JB;Vrochides D;Buell JF;Berber E;Kahramangil B;Troisi RI;Vanlander A;Molinari M;Tsung A
机器人肝脏手术（RLS）已成为腹腔镜或开放切除术的可行替代方案，具有可比的围手术期结局。关于RLS的肿瘤学充分性知之甚少。本研究的目的是研究接受RLS治疗原发性肝胆恶性肿瘤患者的长期肿瘤学结局。我们对2006-2016年期间因肝细胞癌（HCC）、胆管癌（CC）或胆囊癌（GBC）接受RLS的患者进行了一项国际、多中心、回顾性研究。回顾性收集并分析患者的年龄、性别、组织学、切缘状态、手术切除范围、无病生存期（DFS）和总生存期（OS）。在纳入的61例患者中，34例（56%）对HCC进行了RLS，16例（26%）对CC进行了RLS，11例（18%）对GBC进行了RLS。大多数切除术为非解剖性或节段性切除术（39.3%），其次为中央肝切除术（18%）、左外侧肝切除术（14.8%）、左肝切除术（13.1%）、右半肝切除术（13.1%）和右后段切除术（1.6%）。94%的HCC、68%的CC和81.8%的GBC患者实现了R 0切除。中位住院时间为5天，7例患者（11.5%）需要转为开放手术。7例患者发生III-IV级Dindo-Clavien并发症，无围手术期死亡。中位随访时间为75个月（95% CI 36-113），5年OS和DFS分别为56%和38%。当按肿瘤类型分层时，HCC的3年OS为90%，GBC为65%，CC为49%（p=0.01）。RLS可用于原发性肝胆恶性肿瘤，其长期肿瘤学结局与已发表的开放和腹腔镜数据相当。
Robotic liver surgery (RLS) has emerged as a feasible alternative to laparoscopic or open resections with comparable perioperative outcomes. Little is known about the oncologic adequacy of RLS. The aim of this study was to investigate the long-term oncologic outcomes for patients undergoing RLS for primary hepatobiliary malignancies. We performed an international, multi-center, retrospective study of patients who underwent RLS for hepatocellular carcinoma (HCC), cholangiocarcinoma (CC), or gallbladder cancer (GBC) between 2006-2016. Age, gender, histology, resection margin status, extent of surgical resection, disease-free survival (DFS) and overall survival (OS) were retrospectively collected and analyzed. Of the 61 included patients, 34 (56%) had RLS performed for HCC, 16 (26%) for CC, and 11 (18%) for GBC. The majority of resections were non-anatomical or segmental resections (39.3%), followed by central hepatectomy (18%), left lateral sectionectomy (14.8%), left hepatectomy (13.1%), right hepatectomy (13.1%), and right posterior segmentectomy (1.6%). R0 resection was achieved in 94% of HCC, 68% of CC, and 81.8% of GBC patients. Median hospital stay was 5 days and conversion to open surgery was needed in 7 patients (11.5%). Grade III-IV Dindo-Clavien complications occurred in 7 patients with no perioperative mortality. Median follow-up was 75 months (95% CI 36-113) and 5-year OS and DFS were 56% and 38%, respectively. When stratified by tumor type, 3-year OS was 90% for HCC, 65% for GBC and 49% for CC (p=0.01). RLS can be performed for primary hepatobiliary malignancies with long-term oncologic outcomes comparable to published open and laparoscopic data.
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影响因子：
2.6
作者：
Kingham TP;Leung U;Kuk D;Gönen M;D'Angelica MI;Allen PJ;DeMatteo RP;Laudone VP;Jarnagin WR;Fong Y
通讯作者：
Fong Y
DOI：
10.1089/lap.2015.0534
发表时间：
2016-06-01
影响因子：
1.3
作者：
Ahn, Sanghyun;Cho, Ara;Paik, Kwang Yeol
通讯作者：
Paik, Kwang Yeol
影响因子：
3
作者：
Chan, Oliver C. Y.;Tang, Chung Ngai;Li, Michael K. W.
通讯作者：
Li, Michael K. W.
影响因子：
3.6
作者：
Kabbach G;Assi HA;Bolotin G;Schuster M;Lee HJ;Tadros M
通讯作者：
Tadros M
影响因子：
2.7
作者：
Han, Ho-Seong;Yoon, Yoo-Seok;Troisi, Roberto I.
通讯作者：
Troisi, Roberto I.