Objective:To evaluate the application value of Chen's liver-hanging maneuver in robot-assisted laparoscopic right hepatectomy.Methods:Clinical data of 17 patients who underwent laparoscopic right hepatectomy in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from June 2018 to December 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 13 patients were male and 4 female, aged from 19 to 74 years, with a median age of 55 years. In the robot-hanging group, Chen's liver-hanging maneuver was applied in robot-assisted laparoscopic right hepatectomy (n=5), whereas in the robot-no-hanging group, Chen's liver-hanging maneuver was not delivered during robot-assisted laparoscopic right hepatectomy (n=4). In the laparoscopy-hanging group, traditional laparoscopic right hepatectomy combined with Chen's liver-hanging maneuver was adopted (n=8). Perioperative conditions of patients were observed in 3 groups. The liver-hanging time, the time of liver dissection, intraoperative blood loss and the length of postoperative hospital stay among 3 groups were compared by rank sum test. The success rate of liver-hanging maneuver was compared by Fisher's exact test.Results:In the robot-hanging group, liver-hanging maneuver was successfully performed with a success rate of 5/5, and the median time of liver-hanging maneuver was 6(6) min. In the laparoscopy-hanging group, liver-hanging maneuver was successfully conducted in 6 cases with a success rate of 6/8, and the median time of liver-hanging maneuver was 12(11) min. The median time of liver-hanging maneuver in the robot-hanging group was significantly shorter than that in the laparoscopy-hanging group (Z=-2.487, P=0.013), and no significant difference was observed in the success rate between2 groups (P=0.053). No accidental injury to surrounding tissues or blood vessels, or massive bleeding occurred during two surgical procedures. In the robot-hanging, robot-no-hanging and laparoscope-hanging groups, the time of liver dissection was 65(80), 75(80) and 50(50) min, the intraoperative blood loss were 225(450), 300(500) and 225(340) ml, and the length of postoperative hospital stay were 8(12), 10(5) and 13(12) d, respectively. No significant differences were noted among 3 groups (H=2.784, 0.538, 1.857; P>0.05). No postoperative complications or death occurred with postoperative30 d in 3 groups.Conclusions:It is safe and feasible to apply Chen's liver-hanging maneuver in robot-assisted laparoscopic right hepatectomy. Compared with traditional laparoscopic hepatectomy, robot-assisted laparoscopic hepatectomy combined with Chen's liver-hanging maneuver is more convenient and faster.
万方数据
