Outcomes of robotic liver resections for colorectal liver metastases. A multi-institutional analysis of minimally invasive ultrasound-guided robotic surgery.


Journal

Surgical oncology
ISSN: 1879-3320
Titre abrégé: Surg Oncol
Pays: Netherlands
ID NLM: 9208188

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 28 08 2018
revised: 18 10 2018
accepted: 30 10 2018
entrez: 11 3 2019
pubmed: 11 3 2019
medline: 10 7 2019
Statut: ppublish

Résumé

Current evidence supporting robotics to perform minimally invasive liver resection is based on single center case series reporting surgical outcomes in heterogeneous groups of patients. On the contrary, relatively scarce data specifically focusing on secondary hepatic malignancies is available. The objective of this study is to assess short- and long-term outcomes following liver resection for colorectal liver metastasis on a multi-institutional series of patients. All consecutive patients undergoing robotic surgery for colorectal liver metastasis at three different tertiary hospitals over a 10-year time frame were included in this analysis. All patients received ultrasound-guided liver resection according to tumor location following the principle of parenchymal sparing surgery. Perioperative, clinicopathologic and oncological outcomes were assessed. A total of 59 patients underwent liver resection. There were 7 cases of conversion to open surgery. The postoperative complication rate was 27%, 5% being the rate of major morbidity. Overall, the mean postoperative hospital stay was 6 days and no mortality occurred. R0 resection was achieved for 92% of lesions. At a mean follow-up of 19 months, the 1-year and 3-year DFS was 83.5% and 41.9%, while the 1-year and 3-year OS was 90.4% and 66.1%, respectively. Robotic liver surgery does not impair surgical outcome and oncological results in patients with liver metastases from colorectal cancer.

Sections du résumé

BACKGROUND BACKGROUND
Current evidence supporting robotics to perform minimally invasive liver resection is based on single center case series reporting surgical outcomes in heterogeneous groups of patients. On the contrary, relatively scarce data specifically focusing on secondary hepatic malignancies is available. The objective of this study is to assess short- and long-term outcomes following liver resection for colorectal liver metastasis on a multi-institutional series of patients.
METHODS METHODS
All consecutive patients undergoing robotic surgery for colorectal liver metastasis at three different tertiary hospitals over a 10-year time frame were included in this analysis. All patients received ultrasound-guided liver resection according to tumor location following the principle of parenchymal sparing surgery. Perioperative, clinicopathologic and oncological outcomes were assessed.
RESULTS RESULTS
A total of 59 patients underwent liver resection. There were 7 cases of conversion to open surgery. The postoperative complication rate was 27%, 5% being the rate of major morbidity. Overall, the mean postoperative hospital stay was 6 days and no mortality occurred. R0 resection was achieved for 92% of lesions. At a mean follow-up of 19 months, the 1-year and 3-year DFS was 83.5% and 41.9%, while the 1-year and 3-year OS was 90.4% and 66.1%, respectively.
CONCLUSIONS CONCLUSIONS
Robotic liver surgery does not impair surgical outcome and oncological results in patients with liver metastases from colorectal cancer.

Identifiants

pubmed: 30851888
pii: S0960-7404(18)30343-8
doi: 10.1016/j.suronc.2018.10.011
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

14-18

Subventions

Organisme : NIH HHS
ID : S10 OD018164
Pays : United States

Informations de copyright

Copyright © 2018 Elsevier Ltd. All rights reserved.

Auteurs

Francesco Guerra (F)

Division of General, Oncological and Vascular Surgery, Ospedali Riuniti Marche Nord Hospital, Pesaro, Italy. Electronic address: fra.guerra.mail@gmail.com.

Simone Guadagni (S)

Division of General Surgery, University Hospital of Pisa, Pisa, Italy.

Benedetta Pesi (B)

Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.

Niccolò Furbetta (N)

Division of General Surgery, University Hospital of Pisa, Pisa, Italy.

Gregorio Di Franco (G)

Division of General Surgery, University Hospital of Pisa, Pisa, Italy.

Matteo Palmeri (M)

Division of General Surgery, University Hospital of Pisa, Pisa, Italy.

Mario Annecchiarico (M)

Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.

Emilio Eugeni (E)

Division of General, Oncological and Vascular Surgery, Ospedali Riuniti Marche Nord Hospital, Pesaro, Italy.

Andrea Coratti (A)

Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy.

Alberto Patriti (A)

Division of General, Oncological and Vascular Surgery, Ospedali Riuniti Marche Nord Hospital, Pesaro, Italy.

Luca Morelli (L)

Division of General Surgery, University Hospital of Pisa, Pisa, Italy.

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