临床小儿外科杂志2023，Vol.22Issue(12)：1114-1118,5.DOI:10.3760/cma.j.cn101785-202307016-004
全球首例不阻断第一肝门的机器人肝切除术治疗儿童肝母细胞瘤
Robotic hepatectomy in a 14-month-old child of hepatoblastoma without the first hepatic portal control:a first case report in the world
摘要
Abstract
Objective To summarize the surgical experiences of the first-ever global case of robotic hep-atectomy(RH)in a child with hepatoblastoma(HB)without the first hepatic portal control.Methods A 14-month-old HB boy reviewed retrospectively.Located in right hepatic lobe S5/S6,tumor had a dimension of 9.0×6.9 ×6 cm.RH was performed with Da Vinci system.Trocar positioning,operative skills and perioperative managements of pediatric robotic hepatectomy were recorded.Results Without the first hepatic control(Prin-gle),hepatic vessels were ligated by an ultrasonic knife with a Hemo-lock.Tumors(S5,S6,partial S7 & gall-bladder)were completely removed with four robotic arms and one auxiliary hole.Operative duration was 120 min and volume of blood loss 50 ml.There were no such postoperative complications as bile leakage,hemorrhage or infection.Postoperative pathology hinted at HB.Discharge index was attained at Day 7 post-RH.C5V chemo-therapeutic regimen(cisplatin+5-fluorouracil+vincristine)was offered at Day 14.AFP was 36.88,8.90 and 6.61 ng/ml at Month 1,Day 53 and Month 3 post-RH.No new lesions were detected by ultrasonography.Conclusions RH is both safe and feasible for infantile HB without the first hepatic control(Pringle).Currently there are few related reports of RH in children.It is imperative to continue expanding cases and accumulating experiences.关键词
肝母细胞瘤/机器人手术/肝切除术/治疗结果/儿童Key words
Hepatoblastoma/Robotic Surgical Procedures/Hepatectomy/Treatment Outcome/Child引用本文复制引用
徐晓钢,曾纪晓,罗媛圆,刘斐,陶波圆,兰梦龙,梁子建,王欣星..全球首例不阻断第一肝门的机器人肝切除术治疗儿童肝母细胞瘤[J].临床小儿外科杂志,2023,22(12):1114-1118,5.基金项目
国家自然科学基金(82170528) （82170528）
广东省自然科学基金(2022A1515012254) （2022A1515012254）
广州市科技计划市校(院)联合资助项目(202201020612) （院）
广州地区临床特色技术项目(2023C-TS48) （2023C-TS48）
广州市卫生健康科技项目(20231A011040)National Natural Science Foundation of China(82170528) （20231A011040）
Natural Science Foundation of Guangdong Province(2022A1515012254) （2022A1515012254）
Municipality and University(Institute)Joint Grant of Guang-zhou Municipal Science & Technology Plan(202201020612) （Institute）
Guangzhou Municipal Project of Clinical Charac-teristic Technology(2023C-TS48) （2023C-TS48）
Guangzhou Municipal Healthcare Technology Project(20231A011040) （20231A011040）
