Background

Current reports on robotic hepatic caudate lobectomy are limited to Spiegel lobectomy. This study aimed to compare the safety and feasibility of robotic isolated partial and complete hepatic caudate lobectomy.

Methods

Clinical data of 32 patients who underwent robotic resection of the hepatic caudate lobe in our department from May 2016 to January 2020 were retrospectively analyzed. The patients were divided into three groups according to the lobectomy location: left dorsal segment lobectomy (Spiegel lobectomy), right dorsal segment lobectomy (caudate process or paracaval portion lobectomy), and complete caudate lobectomy. General information and perioperative results of the three groups were compared and analyzed.

Results

Among the 32 patients, none had conversion to laparotomy, three received intraoperative blood transfusion (9.38%), and none had complications of Clavien-Dindo grade III or higher or died in the perioperative period. Among them, 17 patients (53.13%) underwent Spiegel lobectomy, 7 (21.88%) underwent caudate process or paracaval portion lobectomy, and 8 (25.00%) underwent complete caudate lobectomy. The operative time and blood loss in the left dorsal segment lobectomy group were significantly better than those in the right dorsal segment lobectomy and complete caudate lobectomy groups (operative time: P = 0.010 and P = 0.005; blood loss: P = 0.005 and P = 0.017, respectively). The postoperative hospital stay in the left dorsal segment lobectomy group was significantly shorter than that in the complete caudate lobectomy group (P = 0.003); however, there was no difference in the postoperative hospital stay between the left dorsal segment lobectomy group and right dorsal segment lobectomy group (P = 0.240).

Conclusions

Robotic isolated partial and complete caudate lobectomy is safe and feasible. Spiegel lobectomy is relatively straightforward and suitable for beginners.

中文翻译：

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机器人隔离部分和完全肝尾状叶切除术：单一机构经验。

背景

目前关于机器人肝尾状叶切除术的报道仅限于 Spiegel 肺叶切除术。本研究旨在比较机器人孤立部分和完全肝尾状叶切除术的安全性和可行性。

方法

回顾性分析我科2016年5月至2020年1月接受机器人肝尾状叶切除术的32例患者的临床资料。根据肺叶切除部位将患者分为三组：左背段肺叶切除术（Spiegel lobectomy）、右背段肺叶切除术（尾状突或腔旁部分肺叶切除术）和完全尾状叶切除术。比较分析三组的一般资料和围手术期结果。

结果

32例患者中，无一例中转开腹，3例接受术中输血（9.38%），无Clavien-Dindo Ⅲ级及以上并发症及围手术期死亡。其中，17例（53.13%）患者行Spiegel肺叶切除术，7例（21.88%）行尾状突或腔旁部分肺叶切除术，8例（25.00%）行尾状叶完全切除术。左背段肺叶切除组的手术时间和失血量明显优于右背段肺叶切除和尾状叶完全切除组（手术时间：P  = 0.010和P  = 0.005；失血量：P  = 0.005和P = 0.017，分别）。左背段肺叶切除组术后住院时间明显短于尾状叶完全切除组（P  = 0.003）；左背段肺叶切除组与右背段肺叶切除组术后住院时间无差异（P  =0.240）。

结论

机器人孤立部分和完全尾状叶切除术是安全可行的。Spiegel 肺叶切除术相对简单，适合初学者。