Short-term outcomes of robotic liver resection: An initial single-institution experience.

Autor:	Durán M; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., Briceño J; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., Padial A; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., Anelli FM; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., Sánchez-Hidalgo JM; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., Ayllón MD; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., Calleja-Lozano R; Unit of Hepatobiliary Surgery and Liver Transplantation, General and Digestive Surgery Department, Reina Sofia University Hospital, Cordoba 14004, Spain., García-Gaitan C; Department of Anesthesiology and Resuscitation, Reina Sofia University Hospital, Cordoba 14004, Spain.
Jazyk:	angličtina
Zdroj:	World journal of hepatology [World J Hepatol] 2022 Jan 27; Vol. 14 (1), pp. 224-233.
DOI:	10.4254/wjh.v14.i1.224
Abstrakt:	Background: Liver surgery has traditionally been characterized by the complexity of its procedures and potentially high rates of morbidity and mortality in inexperienced hands. The robotic approach has gradually been introduced in liver surgery and has increased notably in recent years. However, few centers currently perform robotic liver surgery and experiences in robot-assisted surgical procedures continue to be limited compared to the laparoscopic approach. Aim: To analyze the outcomes and feasibility of an initial robotic liver program implemented in an experienced laparoscopic hepatobiliary center. Methods: A total of forty consecutive patients underwent robotic liver resection (da Vinci Xi, intuitive.com, United States) between June 2019 and January 2021. Patients were prospectively followed and retrospectively reviewed. Clinicopathological characteristics and perioperative and short-term outcomes were analyzed. Data are expressed as mean and standard deviation. The study was approved by the Institutional Review Board. Results: The mean age of patients was 59.55 years, of which 18 (45%) were female. The mean body mass index was 29.41 kg/m². Nine patients (22.5%) were cirrhotic. Patients were divided by type of resection as follows: Ten segmentectomies, three wedge resections, ten left lateral sectionectomies, six bisegmentectomies (two V-VI bisegmentectomies and four IVb-V bisegmentectomies), two right anterior sectionectomies, five left hepatectomies and two right hepatectomies. Malignant lesions occurred in twenty-nine (72.5%) of the patients. The mean operative time was 258.11 min and two patients were transfused intraoperatively (5%). Inflow occlusion was used in thirty cases (75%) and the mean total clamping time was 32.62 min. There was a single conversion due to uncontrollable hemorrhage. Major postoperative complications (Clavien-Dindo > IIIb) occurred in three patients (7.5%) and mortality in one (2.5%). No patient required readmission to the hospital. The mean hospital stay was 5.6 d. Conclusion: Although robotic hepatectomy is a safe and feasible procedure with favorable short-term outcomes, it involves a demanding learning curve that requires a high level of training, skill and dexterity. Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu