Initial experience with robotic liver resection: Audit of 120 consecutive cases at a single center and comparison with open and laparoscopic approaches.


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
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.

Identifiants

pubmed: 35737850
doi: 10.1002/jhbp.1206
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

72-90

Informations de copyright

© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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Auteurs

Yutaro Kato (Y)

Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, Toyoake, Japan.

Atsushi Sugioka (A)

International Medical Center, Fujita Health University Hospital, Toyoake, Japan.

Masayuki Kojima (M)

Department of Surgery, Fujita Health University, Toyoake, Japan.

Gozo Kiguchi (G)

Department of Surgery, Hirakata Kosai Hospital, Hirakata, Japan.

Satoshi Mii (S)

Department of Surgery, Fujita Health University, Toyoake, Japan.

Yuichiro Uchida (Y)

Department of Surgery, Fujita Health University, Toyoake, Japan.

Takeshi Takahara (T)

Department of Surgery, Fujita Health University, Toyoake, Japan.

Ichiro Uyama (I)

Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, Toyoake, Japan.

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