Background: the role of minimally invasive liver surgery has been progressively developed, with the practice increasing in safety and feasibility also with respect to major liver resections. The aim of this study was to analyze the feasibility and safety of major liver resection in elderly patients. Methods: data from a multicentric retrospective database including 1070 consecutive robotic liver resections in nine European hospital centers were analyzed. Among these, 131 were major liver resections. Patients were also divided in two groups (<65 years old and ≥65 years old) and perioperative data were compared between the two groups. Results: a total of 131 patients were included in the study. Operative time was 332 ± 125 min. Postoperative overall complications occurred in 27.1% of patients. Severe complications (Clavien Dindo ≥ 3) were 9.9%. Hospital stay was 6.6 ± 5.3 days. Patients were divided into two groups based on their age: 75 patients < 65 years old and 56 patients ≥ 65 years old. Prolonged pain, lung infection, intensive care stay, and 90-day readmission were worse in the elderly group. The two groups were matched for ASA and Charlson comorbidity score and, after statistical adjustment, postoperative data were similar between two groups. Conclusions: robotic major liver resection in elderly patients was associated with satisfying short-term outcomes.
背景：微创肝脏手术的作用已逐步发展，其安全性及可行性在大型肝切除手术中也得到提升。本研究旨在分析老年患者接受大型肝切除手术的可行性与安全性。方法：本研究分析了来自欧洲九家医疗中心的多中心回顾性数据库，该数据库包含1070例连续进行的机器人肝切除手术数据。其中131例为大型肝切除手术。患者按年龄分为两组（<65岁和≥65岁），并对两组围手术期数据进行比较。结果：研究共纳入131例患者。手术时间为332±125分钟。术后总体并发症发生率为27.1%，严重并发症（Clavien Dindo≥3级）发生率为9.9%。住院时间为6.6±5.3天。根据年龄将患者分为两组：75例<65岁，56例≥65岁。老年组在持续性疼痛、肺部感染、重症监护室停留时间及90天内再入院率方面表现较差。两组患者在ASA评分和Charlson合并症评分方面匹配，经统计学调整后，两组术后数据相似。结论：老年患者接受机器人辅助大型肝切除手术可获得满意的短期疗效。
肿瘤(癌症)患者之家