Initial experience with robotic liver resection: Audit of 120 consecutive cases at a single center and comparison with open and laparoscopic approaches.
anatomic resection
glissonian approach
laparoscopic liver resection
open liver resection
robotic liver resection
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
revised:
09
05
2022
received:
04
01
2022
accepted:
03
06
2022
pubmed:
24
6
2022
medline:
17
1
2023
entrez:
23
6
2022
Statut:
ppublish
Résumé
Surgical outcomes and utility of robotic liver resection (RLR) are undefined. We retrospectively studied perioperative and long-term outcomes of the single-center 120 RLRs including non-anatomic (NAR, n = 58) and anatomic (AR, n = 62) resections. To evaluate the feasibility and safety of RLR, perioperative outcomes of RLR (n = 103) were compared to those of open (OLR, n = 495) or laparoscopic (LLR, n = 451) resection in liver-only resections without reconstruction, using 1:1 propensity score matching (PSM). The changing trends from the earlier to the later RLR cases were assessed. Long-term outcomes were compared between RLR and LLR. Various types of RLR with different surgical difficulties were performed, with mostly comparable postoperative morbidity between AR and NAR, or among AR subtypes. In segmentectomy and sectionectomy cases, perioperative outcomes significantly improved in the later period. In comparison between PSM-selected OLR and RLR cases (87:87), RLR had significantly longer operative time, less blood loss, and shorter hospital stay. PSM-selected LLR and RLR cases (91:91) showed comparable perioperative outcomes. Overall and recurrence-free survivals after RLR for newly diagnosed hepatocellular carcinoma and colorectal metastasis were comparable to those after LLR. RLR is applicable to various types of liver resection with acceptable perioperative and long-term outcomes in select patients.
Sections du résumé
BACKGROUND/PURPOSE
OBJECTIVE
Surgical outcomes and utility of robotic liver resection (RLR) are undefined.
METHODS
METHODS
We retrospectively studied perioperative and long-term outcomes of the single-center 120 RLRs including non-anatomic (NAR, n = 58) and anatomic (AR, n = 62) resections. To evaluate the feasibility and safety of RLR, perioperative outcomes of RLR (n = 103) were compared to those of open (OLR, n = 495) or laparoscopic (LLR, n = 451) resection in liver-only resections without reconstruction, using 1:1 propensity score matching (PSM). The changing trends from the earlier to the later RLR cases were assessed. Long-term outcomes were compared between RLR and LLR.
RESULTS
RESULTS
Various types of RLR with different surgical difficulties were performed, with mostly comparable postoperative morbidity between AR and NAR, or among AR subtypes. In segmentectomy and sectionectomy cases, perioperative outcomes significantly improved in the later period. In comparison between PSM-selected OLR and RLR cases (87:87), RLR had significantly longer operative time, less blood loss, and shorter hospital stay. PSM-selected LLR and RLR cases (91:91) showed comparable perioperative outcomes. Overall and recurrence-free survivals after RLR for newly diagnosed hepatocellular carcinoma and colorectal metastasis were comparable to those after LLR.
CONCLUSIONS
CONCLUSIONS
RLR is applicable to various types of liver resection with acceptable perioperative and long-term outcomes in select patients.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
72-90Informations de copyright
© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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