机器人辅助与开腹半肝切除术：倾向得分分析

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2024-10-09 DOI:10.1016/j.jss.2024.09.001

Xi-Yu Wang MD , Xi-Tai Huang MD , Jian-Peng Cai MD, PhD , Bin Li MS , Wei Chen MD, PhD , Chen-Song Huang MD , Xiao-Yu Yin MD, PhD

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引用次数: 0

摘要

简介机器人辅助手术系统已广泛应用于肝切除术。然而，机器人辅助半肝切除术（RH）的有效性和可行性尚未得到充分证实：本研究纳入了 2010 年 1 月至 2023 年 8 月期间在我院接受机器人辅助半肝切除术（RH）或开腹半肝切除术（OH）的患者。结果：在 163 名连续患者中，有 163 人接受了肝切除术（RH）或开腹半肝切除术（OH）：在确定的 163 例连续患者中，60 例接受了 RH 手术，103 例接受了 OH 手术。经过稳定的逆概率治疗加权调整后，RH 比 OH 失血更少。在亚组分析中，与开放式左半肝切除术相比，机器人辅助左半肝切除术的术后住院时间更短，术后并发症发生率更低，失血量更少。与开腹右半肝切除术相比，机器人辅助右半肝切除术（RRH）失血更少，术中输血率更低，但手术时间更长：RH是一种安全有效的技术。除了失血量少之外，机器人辅助左半肝切除术在术后并发症和术后住院时间方面更具优势，而RRH在术中输血方面更具优势。不过，RRH的手术时间比开放式右半肝切除术长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Robotic-Assisted Versus Open Hemi-Hepatectomy: A Propensity Score Analysis

Introduction

The robotic-assisted surgical system has been widely used in hepatectomy. However, the effectiveness and feasibility of robotic-assisted hemi-hepatectomy (RH) has not been well-documented.

Methods

Patients who underwent RH or open hemi-hepatectomy (OH) performed by a single surgeon at our hospital between January 2010 and August 2023 were included in this study. A stabilized inverse probability of treatment weighting adjusted analysis was performed.

Results

Of the 163 consecutive patients identified, 60 underwent RH, and 103 underwent OH. After stabilized inverse probability of treatment weighting adjustment, RH demonstrated less blood loss than OH. In subgroup analyses, robotic-assisted left hemi-hepatectomy was associated with a shorter postoperative stay, a lower postoperative complication rate, and less blood loss compared with open left hemi-hepatectomy. While robotic-assisted right hemi-hepatectomy (RRH) was associated with less blood loss and a lower intraoperative blood transfusion rate, but a longer operation time compared with open right hemi-hepatectomy.

Conclusions

RH is a safe and effective technique. In addition to less blood loss, robotic-assisted left hemi-hepatectomy had advantages in postoperative complications and postoperative stay, while RRH had advantages in intraoperative blood transfusions. However, operation time was longer for RRH than for open right hemi-hepatectomy.

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.