摘要
目的:总结转化治疗联合机器人根治性肝切除术治疗进展期肝癌的临床效果及优势。方法:回顾性分析2022年8月在南京大学医学院附属鼓楼医院普外科的一例转化治疗后行解剖性右半肝切除的进展期肝细胞癌患者的临床资料。结果:患者接受术前转化治疗(经肝动脉栓塞化学药物治疗经导管肝动脉化学药物治疗栓塞术联合多靶点酪氨酸激酶抑制剂及抗PD1抗体)2个周期后，行机器人右半肝切除术治疗，术中出血量少，术后无感染、出血、胆瘘等并发症，恢复顺利。术后6个月复查肿瘤标志物及相关影像学检查未见明显异常。结论:运用转化治疗理念，结合Laennec入路微创机器人手术技术，提高病理缓解率及手术切除率，从而有望改善进展期肝癌患者的长期预后。
Abstract
Objective:To summarize the feasibility and advantages of robot assisted right hemihepatectomy in a patient with advanced hepatocellular carcinoma underwent conversion therapy.Methods:A retrospective analysis of the clinical data about a patient underwent this novel procedure in the Department of General Surgery, Gulou Hospital Affiliated to the School of Medicine of Nanjing University in Aug. 2022.Results:The patient with advanced hepatocellular carcinoma underwent conversion therapy, whose tumor was successfully downstaged, and received radical surgery. Less intraoperative bleeding, no postoperative infection, bleeding, biliary fistula and so on. Tumor markers and related imaging examinations showed no abnormalities 6 months after the surgery.Conclusions:It is expected to improve the long-term prognosis of patients with advanced hepatocellular carcinoma by applying the concept of conversion therapy combined with Laennec approach minimally invasive endoscopy to enhance the pathological remission rate and surgical resection rate.
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