摘要
目的总结机器人辅助治疗胰腺癌的安全性和可行性。方法对近年来发表的关于机器人胰腺癌手术以及其与传统开放手术和腹腔镜手术的对比分析文献进行综述。结果与传统腹腔镜手术相比较,机器人手术价格昂贵、在吻合和重建方面优势明显;机器人胰十二指肠切除术的手术时间长于开腹手术,但是住院时间和术中失血量却优于开腹手术。与开腹手术相比,机器人胰体尾手术的术中失血量和住院时间少(短)于开腹手术,保脾率优于开腹手术;与传统腔镜手术相比,机器人胰体尾切除术淋巴结清扫数量、R0切缘获得情况、保脾率等方面均优于传统腹腔镜手术。此外,机器人胰腺中段手术和机器人全胰切除术在一些大的中心也被证实是安全和可行的。结论机器人胰腺癌手术是安全和可行的,但目前很多关于机器人胰腺手术的报道均集中在小部分的医疗中心,并且病例的选择也往往是一些早期、肿瘤直径较小的患者,因此目前仍有许多亟待解决的问题。
Objective The aim of this study was to evaluate the safety and feasibility of robot-assisted surgery in pancreatic cancer.Method Recent literatures related to robot-assisted surgery in treatment of pancreatic cancer compared with traditional open surgery or traditional laparoscopic surgery were collected to make an review.Results Compared with the traditional laparoscopic surgery,the robot-assisted surgery was expensive,with the obvious advantages in terms of anastomosis and reconstruction.Compared with the open operation,both robot-assisted pancreaticoduodenectomy and robot-assisted distal pancreatectomy had longer operation time,but the length of hospital stay and intraoperative blood loss were obviously shortened,robot-assisted distal pancreatectomy also had higher spleen preservation rate.Compared with the traditional laparoscopic distal pancreatectomy,the number of lymph node retrieved,R0 resection rate,and splenic preservation rate were also higher in the robot-assisted group.Simultaneously,robotassisted total pancreatectomy and midsection pancreatectomy were deemed as safe in some high-volume centers.Conclusions Robot-assisted pancreatic cancer surgery is safe and feasible,but many surgeries are restricted to a small number of high-volume medical centers,and most cases selected to undergo robot-assisted surgery are often early stage patients with small tumor size.A lot of efforts should be made and problems should be solved.
作者
胡海洁
张永琼
靳艳文
周荣幸
叶辉
程南生
李富宇
HU Haijie;ZHANG Yongqiong;JIN Yanwen;ZHOU Rongxing;YE Hui;CHENG Nansheng;LI Fuyu(Department of Biliary Surgery,West China Hospital of Sichuan University,Chengdu 610041,P.R China)
出处
《中国普外基础与临床杂志》
CAS
2021年第3期390-396,共7页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省科技计划项目(项目编号:2018JY0019)
四川大学火花项目(项目编号:2019SCUH0021)。
关键词
胰腺癌
机器人手术
微创外科
综述
pancreatic cancer
robotic surgery
minimally invasive surgery
review
