Laparoscopic and Robotic Surgery for Splenic Artery Aneurysm: A Systematic Review.
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
19
03
2020
revised:
07
05
2020
accepted:
08
05
2020
pubmed:
2
6
2020
medline:
24
11
2020
entrez:
2
6
2020
Statut:
ppublish
Résumé
Splenic artery aneurysms (SAAs) are the most frequent visceral aneurysms, with a life-threatening risk in case of rupture. Our systematic review investigated the features of minimally invasive surgical approaches in vascular surgery for SAAs: robotic surgery and laparoscopy. PubMed, EMBASE, and the Web of Science were systematically searched for robotic or laparoscopic surgery reports in SAA up to January 2020. The outcomes of the study were operative time, overall morbidity, intraoperative and postoperative complications, conversion rate, and length of hospital stay. A total of 40 studies (29 case reports, 8 case series, 1 randomized trial, 1 video, and 1 image), including 107 patients, were considered eligible for the review. Mean operative time was 164.2 ± 75.9 min (laparoscopy), 165 min (±75.6 min) and 150 min (±87.7 min) for robotic procedures. Four cases of conversion (4.8% of all laparoscopic procedures) were reported; no conversion in the robotic series was reported. Overall morbidity was 11.2%; the most common complications were postoperative spleen infarction and pancreatitis. Medium estimated blood loss was 105.2 mL (±239.5 mL) (robotic 186.6 (±202.4) mL, laparoscopic 63 (0-270) mL). Overall length of stay was 5.43 (±5.5) days (robotic 6.1 days and laparoscopic 5.5 days). Neither mortality nor reinterventions were observed in robotic and laparoscopic series. In accordance with the available literature, laparoscopy and robotic surgery represent, in selected cases, a valid choice to treat SAAs. Multidisciplinary teams, comprehensive of vascular and general surgeons skilled in robotic and laparoscopic procedures, could permit to offer a tailored treatment for each patient. The rarity of this disease does not allow to perform randomized controlled trials; thus the possibility to reach definitive conclusions is currently precluded.
Sections du résumé
BACKGROUND
BACKGROUND
Splenic artery aneurysms (SAAs) are the most frequent visceral aneurysms, with a life-threatening risk in case of rupture. Our systematic review investigated the features of minimally invasive surgical approaches in vascular surgery for SAAs: robotic surgery and laparoscopy.
METHODS
METHODS
PubMed, EMBASE, and the Web of Science were systematically searched for robotic or laparoscopic surgery reports in SAA up to January 2020. The outcomes of the study were operative time, overall morbidity, intraoperative and postoperative complications, conversion rate, and length of hospital stay.
RESULTS
RESULTS
A total of 40 studies (29 case reports, 8 case series, 1 randomized trial, 1 video, and 1 image), including 107 patients, were considered eligible for the review. Mean operative time was 164.2 ± 75.9 min (laparoscopy), 165 min (±75.6 min) and 150 min (±87.7 min) for robotic procedures. Four cases of conversion (4.8% of all laparoscopic procedures) were reported; no conversion in the robotic series was reported. Overall morbidity was 11.2%; the most common complications were postoperative spleen infarction and pancreatitis. Medium estimated blood loss was 105.2 mL (±239.5 mL) (robotic 186.6 (±202.4) mL, laparoscopic 63 (0-270) mL). Overall length of stay was 5.43 (±5.5) days (robotic 6.1 days and laparoscopic 5.5 days). Neither mortality nor reinterventions were observed in robotic and laparoscopic series.
CONCLUSIONS
CONCLUSIONS
In accordance with the available literature, laparoscopy and robotic surgery represent, in selected cases, a valid choice to treat SAAs. Multidisciplinary teams, comprehensive of vascular and general surgeons skilled in robotic and laparoscopic procedures, could permit to offer a tailored treatment for each patient. The rarity of this disease does not allow to perform randomized controlled trials; thus the possibility to reach definitive conclusions is currently precluded.
Identifiants
pubmed: 32479877
pii: S0890-5096(20)30444-1
doi: 10.1016/j.avsg.2020.05.037
pii:
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
527-535Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.