机器人辅助腹腔镜下肝切除术和荧光引导下腹腔镜下肝切除术对肝癌患者的不同影响

凯虔 张(承德医学院附属医院肝胆外科，中国)
士凡 石(承德医学院附属医院肝胆外科，中国)
辉 刘(承德医学院附属医院肝胆外科，中国)
启玉 孙(承德医学院附属医院肝胆外科，中国)
剑 李(承德医学院附属医院肝胆外科，中国)

摘要

目的：论文是研究机器人辅助腹腔镜下肝切除术和荧光引导腹腔镜下肝切除术对肝癌患者的影响。方法：根据治疗方式的不同将100例HCC患者分为对照组（n=50，荧光引导下腹腔镜下肝切除术）和观察组（n=50，机器人辅助腹腔镜下肝切除术）。比较两组的肿瘤标志物、炎症指标水平。结果：观察组患者住院时间均少于对照组，差异均有统计学意义（P＜0.05）。两组手术患者CEA、AFP水平均明显低于本组手术前，观察组患者CEA、AFP水平均明显低于对照组，差异有统计学意义（P＜0.05）。两组手术患者IL-6、NLR和AFR均明显高于本组手术前，观察组IL-6、NLR和AFR均明显低于对照组，差异有统计学意义（P＜0.05）。结论：机器人辅助腹腔镜下肝切除术对HCC患者的损伤较小，提高了手术安全性。

关键词

机器人辅助腹腔镜下肝切除术；荧光引导下腹腔镜下肝切除术；肝癌；肿瘤标志物；炎症指标

参考

Xu L, Xu Y, Zhang F, et al. Immunological pathways in viral hepatitis-induced hepato-cellular carcinoma[J]. Zhejiang Da Xue Xue Bao Yi Xue Ban, 2024 Jan 19;53(1):64-72.

Brown ZJ, Tsilimigras DI, Ruff SM, et al. Management of Hepatocellular Carcinoma: A Review[J]. JAMA Surg, 2023 Apr 1;158(4):410-420.

Yang J, Yang Z, Zeng X, et al. Benefits and harms of screening for hepatocellular carcinoma in high-risk populations: systematic review and meta-analysis[J]. Natl Cancer Center, 2023(3):175-185.

Yang J, Yang Z, Zeng X, et al. Benefits and harms of screening for hepatocellular carcinoma in high-risk populations: systematic review and meta-analysis[J]. Natl Cancer Center, 2023(3):175-185.

谢建立.IGFs在正常人群、HBsAg(+)人群及原发性肝癌患者血清中的表达及临床意义[D].广州:广州医学院,2009.

Tian F, Cao L, Chen J, et al. 3D laparoscopic anatomical hepatectomy guided by 2D real-time indocyanine green fluorescence imaging for hepatocellular carcinoma[J]. Hepatobiliary Surg Nutr, 2024 Jun 1;13(3):494-499.

Sijberden JP, Hoogteijling TJ, Aghayan D, et al. International consortium on Minimally Invasive Liver Surgery (I-MILS). Robotic Versus Laparoscopic Liver Resection in Various Settings: An International Multicenter Propensity Score Matched Study of 10.075 Patients[J]. Ann Surg. 2024 Jul 1;280(1):108-117.

Jiang J, Pei L, Jiang R. Clinical efficacy and safety of 3D vascular reconstruction combined with 3D navigation in laparoscopic hepatectomy: systematic review and meta-analysis[J]. Gastrointest Oncol, 2022 Jun;13(3):1215-1223.

Berardi G, Colasanti M, Meniconi RL, et al. The Applications of 3D Imaging and Indocyanine Green Dye Fluorescence in Laparoscopic Liver Surgery[J]. Diagnostics (Basel), 2021 Nov 23;11(12):2169.

Xuea Q, Wua J, Leia Z, et al. Robot-assisted versus open hepatectomy for liver tumors: Systematic review and meta-analysis[J]. Chin Med Assoc, 2023 Mar 1;86(3):282-288.

中华人民共和国国家卫生健康委员会.原发性肝癌诊疗指南(2024年版)[J].肿瘤防治研究,2024,51(6):495-526.

Gabbia D, De Martin S. Insights into Hepatocellular Carcinoma: From Pathophysiology to Novel Therapies[J]. Int J Mol Sci, 2024 Apr 10;25(8):4188.

马蕊谦,朱翊,肖婉,等.腹腔镜肝切除术下展开肝主流阻断技术治疗原发性肝癌的疗效观察[J].临床和实验医学杂志,2021,20(7):708-712.

彭俊杨,杨培,曾新桃,等.腹腔镜肝中叶切除术治疗原发性肝癌21例报告[J].腹腔镜外科杂志,2020,25(5):352-355.

Wang JM, Li JF, Yuan GD, et al. Robot-assisted versus laparoscopic minor hepatectomy: A systematic review and meta-analysis[J]. Medicine (Baltimore), 2021 Apr 30;100(17):e25648.

Yamamoto M, Kobayashi T, Kuroda S, et al. Impact of postoperative bile leakage on long- term outcome in patients following liver resection for hepatocellular carcinoma[J].Hepatobiliary Pancreat Sci, 2020, 27(12): 931-941.

Mao S, He J, Zhao Y, et al. Bioprinting of patient-derived in vitro intrahepatic cholangiocarcinoma tumor model: establishment, evaluation and anti-cancer drug testing[J]. Biofabrication, 2020 Jul 29;12(4):045014.

Sun H, Sun L, Ke X, et al. Prediction of Clinical Precision Chemotherapy by Patient-Derived 3D Bioprinting Models of Colorectal Cancer and Its Liver Metastases[J]. Adv Sci (Weinh), 2024 Jan;11(2):e2304460.

Zhang L, Yuan Q, Xu Y, et al. Comparative clinical outcomes of robot-assisted liver resection versus laparoscopic liver resection: A meta-analysis[J]. PLoS One, 2020 Oct 13;15(10):e0240593.

Lu X, Liu Q, Yan G, et al. Engineering polyvinyl alcohol microspheres with capability for use in photothermal/chemodynamic therapy for enhanced transarterial chemoembolization[J]. Mater Chem B, 2024 May 29;12(21):5207-5219.

Liu H, Gan XM, Sun JM, et al. Transcatheter arterial chemoembolisation combined with lenvatinib and cabozantinib in the treatment of advanced hepatocellular carcinoma[J]. Int Immunopharmacol. 2024 Mar 30;130:111510.

DOI: http://dx.doi.org/10.12345/yzlcyxzz.v7i10.21650